Document Type

Dissertation

Degree

Doctor of Nursing Practice

Major

Nursing

Date of Defense

11-20-2020

Graduate Advisor

Dr. Susan Dean-Baar

Committee

Dr. Laura Kuensting

Dr. Melinda Cooling

Abstract

Problem: Missed appointments cost primary care facilities money and resources through lack of utilization. When patients fail to attend their scheduled appointment the providers are non-productive when they could be seeing other patients that are potentially moved to other days, sending patients to other providers, or worse sending patients to the prompt care or the Emergency Department for care. The missed appointment rate at Office A Primary Care is approximately ten percent, while Office B has a nearly 11% missed appointment rate. Both facilities make reminder calls to patients the day before their appointments to remind them of their appointment and still there is a significant missed appointment rate.

Methods: This project includes an observational, descriptive design utilizing retrospective data collection from the medical record of patients from the calendar year 2019 with a comparison between the two primary care offices (Office A and B) and evaluation if the prompt care at Office A impacts the missed appointment rates.

Results: Results showed a significantly less likely rate of missed appointments at Office A than at Office B. Additionally, those that did miss their appointment at Office A were more likely to have an urgent care visit than those that missed visits at Office B. This is greatest for regular office visits and preventative exams, as well as, for those with a payor source of Medicare. Younger individuals were more likely to miss their appointments than older individuals.

Implications for Practice: Further studies and investigation is needed to find ways to reduce missed appointment rates. While both offices have relatively low rates, it would improve productivity and profitability to reduce the missed appointments, as well as improve patient outcomes. Additionally, it is assumed that there are times when the patient misses their appointment and ultimately ends up in the emergency department.

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