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This presentation discusses strategies to improve attendance rates in a pediatric weight management clinic and the impact on patient outcomes. Measures, interventions, and outcomes are presented.
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Improving Attendance in the Pediatric Weight Management Clinic Claudia Fox, MD, MPH MMRB presentation 10-11-18
Disclosure • Funding: none
Quality Gap • Childhood obesity is a chronic medical condition • Obesity treatment requires regular contact with treatment team • Patient attendance at appointments is poor • Cancellations • No-shows • Consequences of poor attendance include poor patient outcomes and limited clinic access
Quality Gap • Identify patient no-show rate and test strategies to reduce no show rate
AIM “Our aim is to reduce the no-show rate of patients attending the Pediatric Weight Management Clinic by 20% by September 1, 2018.” Measures: - Clinic No-show rate (outcome – process) - # of patients who no-showed/tot # scheduled
Interventions • Reminder phone calls • Students call all new and f/u patients on Dr. Fox’s schedule for month of 10/2016 • Up to 3 attempts • Left message on 3rd attempt • Outcome measured 11/2016 • Informing patient of no-show policy • No-show policy: after 2 no shows for new appt and 3 for a f/u appt, pt is asked to seek care elsewhere • Scheduler verbally discusses this policy with all patients in month of 5/2018 • Outcome measured 8/2018
Outcomes – No-show rate • Cycle 1 • Before intervention 21% (16/75) • After intervention 21% (18/86) • Cycle 2 • Before intervention 17% (11/59) • After intervention 15% (11/72)
Spread, Sustain, Impact • We stopped student led reminder calls • We continue to remind patients of no-show policy at time of making appointments • This activity has not made significant impact on my individual practice as there continues to be unscheduled slots in schedule • Surprised by relatively low no-show rates • Next gap to address is late cancellations