Effect of standard of care changes on the no-show rate in a sickle cell clinicHornak, Brooke (2017) Effect of standard of care changes on the no-show rate in a sickle cell clinic. Master's Thesis, University of Pittsburgh. (Unpublished)
AbstractBackground: Lack of appointment compliance is a problem that is consistent throughout outpatient clinics. Research has found that personal phone calls as opposed to automated systems can improve appointment compliance. Another barrier that has been identified is the frequency of appointments. For individuals with sickle cell disease, attending appointments is important for managing their medications and multi-disciplinary care. In this study, we seek to determine whether 2 standard of care changes have impacted the no show rate in a sickle cell clinic based at Children’s Hospital of Pittsburgh of UPMC (CHP). Methods: Clinical data were reviewed to assess the impact of these changes on the no-show rate before and after these changes were made. Statistical analysis was performed utilizing paired analysis and summary statistics. All patients who were followed in clinic at CHP both during a set time period before and after implementation and met inclusion criteria were included in the assessment. Results: Changes to the appointment frequency for hydroxyurea patients and the personal reminder phone calls did not statistically significantly change the no-show rate with a p-value 0.6818 and 0.3421, respectively. There were 67 patients included in the hydroxyurea appointment frequency and 101 included in the phone call reminder portion. Conclusions: Reducing the frequency of appointments in the subset of patients taking hydroxyurea and phone call reminders did not increase appointment compliance, but further research needs to be conducted to determine the full impact of these interventions. Methods to increase appointment compliance are especially important in the sickle cell disease population, as attending appointments is how medications and preventative and symptomatic care are managed. Further research needs to be done on barriers to access to understand why patients are not attending appointments before new implementations can be made. Public Health Significance: Appointment compliance is important for keeping individuals healthy through preventative measures, following up with a chronic condition, and making the best use of health care resources. Share
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