Improving Outpatient Psychiatric Appointment Attendance

Mental health issues are a growing concern for individuals and the public. When patients do not attend their mental health appointments they place themselves at risk for poor health outcomes including worsening of symptoms, relapse, hospitalization, or danger to self and other behaviors. The breadth, background, and significance of this issue were investigated to determine a clinically relevant PICOT question. These elements of the PICOT question were investigated and high-quality evidence was gathered, analyzed, and synthesized in order to develop recommendations for an evidence-based project to help with no-shows at a non-profit integrated healthcare organization that is experiencing a high incidence of no-shows. The Quality Health Outcomes Model and Ottawa Model of Research Use guide the implementation and monitoring of the project.

A chart review was completed in order to understand the impact of a novel automated reminder system on the no-show rate for all psychiatric appointments for 18 months. Additionally, demographic and appointment information was gathered to identify trends in the data and factors related to appointment status. The no-show rate significantly increased in 2019 with the new reminder system. No-shows occurred significantly more in males, tele-medicine appointments, and hospital discharge appointments. There were significant differences in no-show rates observed between reported races, with different providers, and at different practice locations. This gap analysis has provided insight into further projects and work to be completed in order to decrease no-shows, improve treatment compliance, produce better health outcomes, and increase revenue for this organization.