Penzias Rebecca, Sanabia Virginia, Shreeve Kyra M, Bhaumik Urmi, Lenz Caitlin, Woods Elizabeth R, Forman Sara F
Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, MA.
Office of Community Health, Boston Children's Hospital, Boston, MA.
Pediatr Qual Saf. 2019 Jul 29;4(4):e192. doi: 10.1097/pq9.0000000000000192. eCollection 2019 Jul-Aug.
Nationally, hospital practice missed appointment rates are high. Our goal was to reduce the rate of missed appointments in an Adolescent/Young Adult Practice through quality improvement methods.
During the 12-month intervention period, administrative staff called patients the day before their primary or specialty care appointments to remind them of the date, time, and location, as well as patients who did not attend their appointments to ask about the reason for their missed appointment. We implemented Plan-Do-Study-Act interventions and analyzed data to compare missed appointment rates between the 12 months before and after February 1, 2017, the project intervention date.
Results showed significant reductions in the missed appointment rate for the Adolescent/Young Adult Practice. A control chart showed a shift in the mean overall percent of completed appointments from 76.7% to 79.2%. The most common reasons for missed appointments included forgetting (39.2%), conflicts with work/school (11.0%), or emailing the provider without contacting administrative staff (7.8%). There were significant reductions in missed appointment rates for both males and females as well as patients who were ≥20 years old, identified English or Spanish as their primary language, had public or private insurance, identified as Black or Hispanic, or did or did not require an interpreter.
These data show that targeted interventions such as personalized reminder calls can be effective in reducing patient missed appointment rates in Adolescent/Young Adult Practices.
在全国范围内，医院的预约失约率很高。我们的目标是通过质量改进方法降低青少年/青年成人诊所的预约失约率。
在为期12个月的干预期内，行政人员在患者进行初级或专科护理预约的前一天打电话提醒他们预约的日期、时间和地点，对于未赴约的患者则询问其失约原因。我们实施了计划-执行-研究-行动干预措施，并分析数据以比较2017年2月1日（项目干预日期）前后12个月的预约失约率。
结果显示青少年/青年成人诊所的预约失约率显著降低。控制图显示完成预约的总体平均百分比从76.7% 上升至79.2%。失约的最常见原因包括忘记（39.2%）、与工作/学校冲突（11.0%）或未联系行政人员就给医生发邮件（7.8%）。男性和女性以及年龄≥20岁、将英语或西班牙语作为主要语言、拥有公共或私人保险、被认定为黑人或西班牙裔、需要或不需要口译员的患者，其预约失约率均显著降低。
这些数据表明，诸如个性化提醒电话等有针对性的干预措施可有效降低青少年/青年成人诊所患者的预约失约率。
