Effecting change in outpatient failed appointments.

The problem of failed appointments was addressed in a family practice clinic. This study borrows an approach toward increasing clinic attendance that has had consistent and positive results in mental health settings: pretherapy induction. The previsit induction was intended to prepare the patient for entry into a medical system, altering erroneous and unrealistic expectations of the patient, which, if left unaddressed, can lead to patient frustration and subsequent noncompliance. Four hundred sixty patients were each randomly assigned to one of three groups. One group viewed a 20-minute videotape introducing the clinic, its staff, and services, and how to utilize the staff during and outside office hours. A second experimental group received the same information in pamphlet form. The control group received no information about clinic function except that which was requested by the patient. Eleven months after onset of the study all patient charts were reviewed. Compared with both the no-treatment control group and the pamphlet experimental group, significantly fewer new patients viewing the induction videotape missed subsequent scheduled appointments (P less than .025). This same group had a significantly lower number of missed appointments during the study period (P less than .05).