Evaluating Telehealth and In-Person Appointment Adherence Using Reminder Phone Calls in the Outpatient Psychiatric Setting

Abstract

OBJECTIVES: Missing outpatient psychiatric care could lead to decompensation and hospitalization. The purpose of this quality improvement project was to implement reminder phone calls in the outpatient psychiatric setting and measure the impact on appointment adherence. METHODS: Reminder phone calls were provided by three clinic staff to patients the day before their scheduled appointment during a 9-week intervention period. Due to seasonal appointment attendance variation, attendance during the 9-week period was compared to the same 9-week period the year prior. RESULTS: A total of 837 appointments were evaluated, and 16.25% resulted in missed appointments. In-person no-show percentages were different from 1 year to the next, while telehealth no-show percentages were not. The overall no-show rate for in-person visits was 21.39%, while telehealth was 12.63%. CONCLUSION: There may be many reasons for a missed appointment, with forgetting an appointment being only one of them. Despite a reminder phone call, appointment attendance did not significantly improve. Providers may want to consider flexible scheduling from in-person to telehealth appointments as a way to improve attendance, given that telehealth appointment attendance is higher and may eliminate transportation concerns. Future studies should evaluate flexible scheduling as well as multi-pronged interventions that address several reasons for non-attendance.