Automated Reminder: An Effective Approach to Reduce No-Show Rate in Diet Clinic?

Objective: No-show or missed appointments are common occurrences in health care including dietetics outpatient clinics where it can negatively affect patients short and long term well-being due to missed opportunity to address patients nutrition issue in a timely manner. Therefore, a sequential clinical audit was conducted to identify the reasons of no-show and to propose along with implementation of remedial measure to reduce the no-show rate in diet clinic.

Methodology: The pre-remedial phase of the study was conducted from June to September 2017 at Hospital Sultan Ismails diet clinic. Using system data, no-show cases were identified. No-showers or guardian of no showers were contacted to record the reason for no-show appointments. Descriptive analysis was used to analyze the results. Re-audit was conducted after implementation of remedial phase.

Results and Discussion: A no-show rate of 40.7% was found in the initial phase of the study. 102 patients were contacted (34%, n=102) to identify their reason of missed appointments to diet clinic. Paediatric patients aged 1 to 3 years contributed the highest percentage of no-show (49%, n=50). The major reasons identified for no-show are forgetting and remembered wrong appointment date (35.3%, n=36), followed by ill or admitted to ward (13.7%, n=14) and others (12.7%, n=13) such as personal issues and school examination. Automated reminder via broadcast with Short Message Service (MySMS) was implemented to target the major reason for no-show which resulted in a reduction of no-show rate to 22.2%.

Conclusion: No-show appointments are found to be prevalent. Remedial measure using Short Message Service (MySMS) is found to be effective in reducing no-show rate. Periodic audit is needed to ensure continuous effectiveness of remedial measure. However, further studies need to be conducted in weighing the cost effectiveness of this method for long term run.