Impact of Pre-Procedure Interventions on No-Show Rate in Pediatric Endoscopy

Abstract

Pediatric endoscopy has evolved into an indispensable tool in the diagnosis and management of gastrointestinal diseases in children. However, there is limited literature focusing on quality improvement initiatives in pediatric endoscopy. The primary goal of this project was to reduce the no-show rate in the pediatric endoscopy unit. Also, we aimed to improve patient and family satisfaction with the procedure by identifying opportunities for improvement. A checklist was designed based on the potential causes of no-show. The endoscopy nurse coordinator reviewed the checklist when scheduling the procedure to identify patients at high risk for non-compliance. Once a risk factor was identified, appropriate actions were taken. She also made a pre-procedure phone call as a reminder and to address any of these risks for non-compliance if present. A patient satisfaction survey was used to identify potential areas for improvement. The no-show rate decreased from an average of 7% in the pre-intervention phase to 2% in the post-intervention phase (p = 0.009). 91% of the patients/family recorded an overall satisfaction of 4 or 5 on a scale of 1–5 (5 being best). Quality improvement strategies decreased the no-show rate in the pediatric endoscopy unit. A patient satisfaction survey helped in identifying areas for improvement.

Predicting no-shows in paediatric orthopaedic clinics

“…For paediatric orthopaedics, resolution of pain that drove scheduling the appointment in the first place can result in NS. Previous authors have documented factors related to increased time between events, such as transportation issues and absence of adequate reminder system for the appointment 9 22. The latter risk factor has been studied extensively and therefore has the most data available regarding causes and viable options to resolve NS.…”

“…Research has demonstrated that there are a number of tools that can be used to mitigate this risk, including telephone reminders, social worker visits and focused efforts to provide appointments closer to the day of scheduling. These methodologies have demonstrated effectiveness in the previous publications outside paediatric orthopaedics 8 9. The data available to us through our EHR did not contain the details of transportation or the request for additional interim reminders of the pending appointment.…”

“…Existing studies have pointed to various potential risk factors for appointment non-attendance, which included transportation issues, number of chronic illnesses or severity of illness, time between scheduling and appointment, lack of reminders, perceived benefit, and socioeconomic status 9–17. The concern regarding NS patients in the paediatric orthopaedic clinic is significant because of the possibility of long-term detrimental outcomes related to growth plate pathology or potentially treatable musculoskeletal diseases that go untreated with risk for early adulthood debilitation.…”

Attend: A Two-Pronged Trial to Eliminate No Shows in Diagnostic Imaging at a Community-Based Hospital

“…Thus, the researchers developed a package to be sent to patients, which resulted in a decrease in the no-show percentage to less than 1% of appointments scheduled [10]. Overall, the literature confirms that an improvement in communication, either through direct contact or issuing information packages before the appointment, has been effective in reducing no-show percentages [4,[8][9][10].…”

“…The issue of no shows is one that is understated while having serious implications on the productivity of the system; it also impacts the quality of care being delivered to patients [4]. It is estimated that the cost to perform an MRI scan is approximately $300 CAD (Canadian dollars), so although the scan may not run, the preparation required before a patient is scanned takes up time and resources [5].…”