A Quality Improvement Project to Reduce the ‘No Show’ rate in a Paediatric Neurology Clinic

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Abstract

This quality improvement project aimed to reduce the 'no show' rate in a paediatric neurology clinic in Qatar.

No show, in outpatient clinics, is defined as patients who fail to attend their scheduled clinic appointments. It is one of the targets for improving quality of care. It leads to longer waiting times for patients to be seen in outpatient clinics, and the result is patients missing their important appointments. It also results in a waste of the clinic resources, and physician and other healthcare practitioners' time.

This study was undertaken as part of the CCITP (clinical care improvement training programme). A project team was assembled with coaching support. The department chairman and the appointment system personnel were involved. Baseline and ongoing measures were collected and charted.

The baseline no-show rate was identified as 49%. Following three intervention PDSAs, mainly addressing communication and appointment flexibility, the post intervention no-show rate dropped to 18% and was sustained below the target of 25% for two years.

Better communication and appointment flexibility can significantly reduce the no-show rate in outpatient clinics.

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Reduction and management of no-shows by family medicine residency practice exemplars.

Bradley J. Johnson, James Mold, J Pontious (2015)

We wanted to describe the methods used by family medicine residency practices with low no-show rates (rate exemplars) and those able to keep visit rates high despite no-shows (management exemplars). Program directors of US family medicine residency programs were asked to respond to a survey questionnaire. Telephone interviews were conducted with the administrators of rate exemplars (no-show rates of 10% or less) and management exemplars (average of 8 to 10 patient visits per half-day plus high administrator satisfaction with no-show management strategies). Directors of 14 rate and 8 management exemplars, identified from among the 141 practices (31.5%) that returned the initial survey instrument, were interviewed and subsequently resurveyed. All of the rate exemplars used multiple strategies, including patient education, patient reminders, patient sanctions, and some degree of open-access scheduling. Practices that managed no-shows well encouraged walk-ins and work-ins and overbooked resident schedules either equally or based upon individual no-show rates. Practice exemplars of both types were highly committed to addressing the no-shows problem and were diligent about following their policies and procedures regarding no-shows. Some family medicine residency practices are able to achieve low no-show rates or keep them from affecting practice volume. Those that do use combinations of well-established methods.

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A multi-method intervention to reduce no-shows in an urban residency clinic.

Clark DuMontier, Kirsten Rindfleisch, Jessica Pruszynski … (2013)

Missed appointments can create financial, capacity, and continuity issues in primary care. An urban family medicine residency teaching clinic with a large culturally diverse population of low-income patients struggled for decades with a persistent no-show rate of 15%--17% despite multiple attempts to remind patients or otherwise address the problem. This study sought to measure the effects of a multi-method approach to decreasing the overall clinic no-show rate over time.

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Author and article information

Journal

Journal ID (nlm-ta): BMJ Qual Improv Rep

Journal ID (iso-abbrev): BMJ Qual Improv Rep

Journal ID (hwp): bmjqir

Journal ID (publisher-id): bmjqir

Title: BMJ Quality Improvement Reports

Publisher: British Publishing Group

ISSN (Electronic): 2050-1315

Publication date Collection: 2016

Publication date (Electronic): 31 August 2016

Volume: 5

Issue: 1

Electronic Location Identifier: u209266.w3789

Affiliations

HMC/Qatar

Article

Publisher ID: bmjqir.u209266.w3789

DOI: 10.1136/bmjquality.u209266.w3789

PMC ID: 5015818

SO-VID: b213fd1a-3440-42bc-a7ce-85ca5615bb4f

Copyright © © 2016, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

License:

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See:

History

Date received : 25 February 2016

Date revision requested : 3 May 2016

Date revision received : 1 June 2016

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