Reducing the No Show Rates for Mental Health Appointments among Young Adults

Practice Problem: Missed patient appointments have become an increasingly significant issue for healthcare organizations, private practices, and clinics. No show appointments can negatively impact the operational functions of these organizations including lost revenue. The clinical practice site’s pre-intervention no-show rate for young adult mental health appointments was 21%. The high percentage of missed mental health visits has resulted in both lost revenue for the clinic and disruptions in patient care. PICOT: The PICOT question that guided this project was: In young adults 18-25 years with mental health appointments (P) how does patient preferred appointment reminders (I) compared to standard appointment reminders (C ) affect no show rates (O) within 8 weeks (T)? Evidence: Current evidence demonstrates that patient appointment reminders improve the overall adherence rates of patient appointments thus providing support for the utilization of patient preferred appointment reminders for young adult mental health appointments to mitigate the high rate of no shows. Intervention: The proposed practice change of preferred patient reminders was implemented in response to the high number of no-show rates of mental health appointments in the student and employee clinic. The intervention focused on changing the clinic’s standard practice of phone call reminders two days prior to appointments with the evidence-based intervention of patient preferred appointment reminders. Patient preferred reminders included telephone and/or email reminders based on patients’ preference one week before and the day before scheduled appointments. Questionnaires were provided to ascertain patients’ preferences, thereby allowing patient involvement in the process. Comparison: The intervention was compared against the facility’s current practice standard of providing reminder cards with appointment dates and times and phone call reminders two days before appointments. Outcome: The anticipated outcome was a reduction in missed appointments. As a result of the evidence-based intervention of preferred patient reminders, the number of missed appointments was reduced to 15%, two percent greater than predicted. Time: The project was completed within the predicted 8-week timeframe Conclusion: Evidence supports the use of patient preferred appointment reminders in reducing the number of no-show appointments. The patient preferred appointment reminders utilized by the registration and nursing staff throughout the practice change project resulted in a significant reduction in no-show rates of mental health patients in the student and employee clinic.