Reasons for non-attendance: audit findings from a nurse-led clinic

Abstract

BACKGROUND AND CONTEXT: Evidence has shown that non-attendance at clinics occurs for a variety of reasons and impacts negatively on client outcomes and effective use of clinic resources. This paper reports an audit of non-attendance at Care Plus and diabetes clinics undertaken between October 2007 and October 2008, in a large general practice in the Wellington region. ASSESSMENT OF PROBLEM: A retrospective and prospective audit of the non-attendance rate at nurse-led wellness clinics was completed using the Query Builder function in Medtech32, collecting data from 142 people who did not attend a scheduled appointment. RESULTS: Thirty-three people were unable to be contacted about their reason for not attending. Of those contacted, 68 did not attend because they were unaware of the appointment, confused regarding the appointment time, or simply forgot. Eighty-four people were aged between 18 and 65 years, yet of those contacted, only four cited work had prevented their attendance at the clinic. Difficulty with transport was reported by only two people. STRATEGIES FOR IMPROVEMENT: The audit highlighted the importance of administration processes for scheduling routine appointments and reminding patients about appointments. It provided evidence that administrative support for nurse-led clinics is necessary. LESSONS: Involvement in clinical audit was a new experience for many of the staff and the usefulness of the findings led to more positive views about how audit can be used. The importance of appropriate administrative support was highlighted. Lessons learned for future audits included the importance of a complete data set and consistent use of codes for data entry. KEYWORDS: Audit; primary care; non-attendance

A consultant‐led anticoagulation review of all patients in one clinical commissioning group to prevent atrial fibrillation related stroke

“…This was possible because of the call and recall method used and telephoning patients 1‐week prior to the appointment and a further remainder the day before. The importance of telephone reminders has been noted in other studies . It is also felt that the novel approach of having local hospital based Consultants attending patients local GP practices, bringing care closer to home, was an important factor in ensuring the highest number of patients attended face‐to‐face consultations.…”

“…The importance of telephone reminders has been noted in other studies. 34,35 It is also felt that the novel approach of having local hospital based Consultants attending patients local GP practices, bringing care closer to home, was an important factor in ensuring the highest number of patients attended face-to-face consultations.…”

Factors affecting follow-up non-attendance in patients with Type 2 diabetes mellitus and hypertension: a systematic review

“…(16,24,25,30,32,(35)(36)(37)(38)(39) Commonly cited reasons related to the patient included: work commitments; having a busy schedule or having alternative appointments; the perception that their DM was not dangerous or that they were not ill enough; the inability to afford clinic or medication expenses; having forgotten their appointment; or transport difficulties. (16,24,25,30,32,(35)(36)(37)(38)(39) As for reasons related to healthcare providers, transport logistics such as cost and lack of accessibility, as well as patients perceiving the clinic sessions to be useful, were cited in most of the studies. (16,25,30,32,(35)(36)(37)(38)…”

A qualitative study of staff perspectives of patient non-attendance in a regional primary healthcare setting

“…Non-attendance prevents efficient healthcare delivery, [1][2][3] results in inefficient use of staff, and illness prevention is compromised when people do not attend scheduled follow-up appointments. [4][5][6] Previous studies suggest that non-attendance is caused by negative patient-staff relationships, patients' perceived knowledge about the diseases and patients' experience with treatment regimens, 5 forgetfulness, 2,7-9 administrative errors regarding making and cancelling appointments, lack of transport, [8][9][10] and that forgetfulness is the most common reason for non-attendance at scheduled appointments. 7,8 However, other factors such as low socioeconomic status, age and gender, are associated with non-attendance in high income countries.…”