Impact of Structured Telephone Communication on Patient No-Show Rates in an Outpatient Specialty Clinic

Missed appointments, or no-shows, are becoming a major problem for many healthcare systems. A neurology outpatient clinic had an increasing no-show rate with no standardized method in place to remind patients of their appointments. The purpose of this quantitative quasi-experimental quality improvement project was to determine if the implementation of the Agency for Healthcare Research and Quality (AHRQ) Re-Engineered Discharge (RED) Toolkit telephone communication would impact no-show rates among adult patients in a specialty outpatient clinic in Southwest Idaho over four weeks. Neuman’s system model provided the theoretical framework for this project. The total sample size was 10 providers and 2,483 patient appointments. Data were collected from the NextGen Electronic Health Record (EHR). Across the 10 providers, there was a total of 2,483 patient appointments evaluated, n=1,267 in the pre-implementation period and n=1,216 post-implementation period. No-show rates for the 10 providers were compared between pre- and post-implementation using a paired t-test. Results indicated that although there was a clinically significant decrease in no-show rates from pre- (M = 12.2%, SD = 6.7%) to post-implementation (M = 8.4%, SD = 4.0%), it was not statistically significant t (9) = 2.143, p =.061. Therefore, implementation of the AHRQ RED Toolkit telephone communication may impact no-show rates among adult patients. It is recommended that the project is sustained at the project site with continued analysis to determine if statistical significance and clinical significance can be made over a longer period of time with larger sample sizes.