Background Non-attendance in clinics has a major economic impact in the National Health Service. Literature review indicates that the major reason for non-attendance is patients or parents forgetting their appointment and reminders before clinic appointment reduces the “did not attend” (DNA) rate. Telephone call reminders were introduced for all paediatric outpatient appointments from February 2014 in our District General Hospital setting.
Aim We aimed to evaluate the DNA rate at the paediatric outpatients after implementation of telephone reminders.
Methods Using our hospital outpatient database, DNA rates were reviewed for 6 months (Feb–July 2013) and compared with the DNA rates for similar duration in 2014 (before and after the introduction of reminders). For Feb–July 2014 period, comparison was also made for patients who confirmed attendance during reminders versus those left a voice message and those who didn’t receive a call or did not answer.
Results Total number of patients in 6 months (2013) were 4156 [2674 follow-up (F/U), 1482 New] and 4732 (3100 F/U, 1632 New) in 2014 (Figure 1). Overall DNA rate for both F/U and New appointments in 2014 was 11.4% (post intervention), which was 5.1% (p value < 0.0001) lower than the total DNA rate in 2013 (16.5%). Although reduction was noticed in both F/U and New appointments but it was only statistically significant in follow up (6.9%, p value <0.0001) compared to new appointment (1.7%, p value 0.1470).
DNA rate was lowest at 3.4% in the patients who answered and confirmed the appointment. Patients confirming attendance were less likely to DNA compared to those patients who had voice messages (10.98% DNA, p value 0.0041) or not answering phone/not called (13.65% DNA, p value 0.0001).
Conclusion Our results endorse the usefulness of telephone reminders and validates that confirmation of clinic appointment plays a significant role in reducing the DNA rate in the Paediatric outpatient setting. Telephone reminders and text messaging are extremely cost effective interventions, and hence routine reminders with confirmation of appointment should become standard NHS practice.
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