Reducing No-Show Rates at an Urban Community Health Center
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2018-05
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University of Hawaii at Manoa
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Missed appointments or “no-shows” are known to interfere with the continuity of patient care, contribute to health consequences, and increase hospitalization rates. The aim of this Doctoral in Nursing Practice (DNP) quality improvement project was to implement evidence-based (EB) practice interventions to reduce the no-show rate at Kalihi Pālama Health Center (KPHC). The Stetler Model was used as a framework to guide this DNP project. A review of the literature revealed that a combination of interventions was most effective to reduce no-show rates. A combination of motivational interviewing, open access scheduling, and patient education was implemented for five months at KPHC’s main clinic. All new and established patients from the Adult Medicine Department who missed an appointment between July to November 2017 received a follow-up phone call by a medical assistant (MA) or community health worker (CHW). Staff attended two one-hour motivational interviewing trainings and bi-monthly team meetings to evaluate the practice change. A pre- and post-questionnaire was given to staff and a no-show report was generated six-months prior to implementation and post-implementation. As a result, the no show rate reduced from 19.8% to 16.8%. The feedback received from staff showed that following up with no-show patients using the three interventions helped increase appointment attendance and appropriate cancellations/rescheduling. This indicates that the combination of interventions was effective in reducing patient no-shows, increasing staff engagement with patients, and; ultimately, increasing patient access to health care and improved health outcomes.
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No shows, missed appointments, community health centers
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