Analysis of Missed Patient Appointments

The cardiac outpatient patient care system which operates on scheduled appointments for follow-ups, usually is overbooked with patients allocated time to be seen during the week by the cardiologists as per need. Due to the shortage of the specialized doctors, appointment schedules for patients are limited and based on patient care priority needs. Patients who miss the scheduled appointments are considered no-shows and any other appointment is scheduled as a low priority appointment at a later date. The opportunity missed is not replaced and leads to deserving patients getting delayed to be seen, wastage of scarce resources, and lower patient care outcomes of care (Kaplan-Lewis & Percac-Lima, 2013). The current patient care system at the hospital utilizes the outpatient clinic for cardiac patients to ensure effective follow-ups for patient following discharge.

This bottleneck creates a vacuum which hinders the effectiveness of care prioritization impacting the quality of the care delivered to the patients. The identified systematic failures in relation to the missed patient care appointments and follow-ups have been identified through the analysis of the trends in missed patient appointments. An analysis of the missed appointments by patients indicate that most of the missed appointments were from discharged patients compared to those appointments made to the walk-in outpatient patients. This is often because the walk-ins are scheduled following consultation where they are educated on the need for the visit, and are often able to make a decision on the date of their appointment. Discharged patients following the rigorous discharge process, lack of effective coordination between the inpatient and outpatient clinics and ineffective communication system hence difficulties associated with the honouring of the scheduled visits.

To further gunner support for change, evidence-based information will be shred with providers as well as management on the efficiency of the patient portal in scheduling patient appointments and their care. The effectiveness of the intervention will be monitored through the collection of patient data on the rate of honouring their appointments prior to the introduction of the patient portal and data on the appointments following the intervention. Data will involve patient exit interviews and data from key informers such as staff. Financial data on the cost of missed appointments will also be collected and comparative analysis of the two made to inform the impact of the intervention on the effectiveness in reducing the wastage in costs by missed appointments. The comparative analysis of financial data as well as the rates of patient satisfaction with the new intervention is essential in informing the effectiveness of the process in enhancing the setting of the patient appointments and the level of patient-centredness of the process.

Encouraging Patient Portal Use in the Patient-Centered Medical Home: Three Stakeholder Perspectives.  Journal of Medical Internet Research, 18(11), e308. doi: 10. 2196/jmir. 6488 Irizarry, T. doi: 10. 1177/2150131913498513 Khammarnia, M. , Haj Mohammadi, M. , Amani, Z. , Rezaeian, S. et al. Reducing Patient No-Shows: An Initiative at an Integrated Care Teaching Health Center.  The Journal of The American Osteopathic Association, 118(2), 77. doi: 10. 7556/jaoa. The data will inform on the cost of no-shows to the hospital, the impact no-shows have on the progress of the patient’s outcomes and the rate of readmissions for no-shows compared to those who meet their healthcare needs. A review of literature on the use and effectiveness of the patient portal in minimizing patient’s missed appointments and in enhancing follow-up care. A detailed analysis of the situation will be shared with the hospital management to provide an evidence of the gaps and catalyze the need to implement the intervention.