Improvement of appointment compliance in an underserved lupus clinic

Abstract

Background: To identify major obstacles to appointment compliance and quantify a measurable effect of a simple phone call intervention on the clinic show rate. Methods: We retrospectively looked at the show rates from November 1st, 2013 to June 30th, 2014 at our Lupus clinic, which is located in Bronx, NY. The scheduled patient chart was crosschecked if the patient made it to the appointment by verifying the provider note. A patient survey was implemented over a period of 8 weeks from July 1st, 2014 to August 12th, 2014. A reminder phone call intervention 2-3 days prior to the visit was planned. The intervention was implemented from September 1st, 2014 to April 30th, 2015. Data was analyzed after the end of the intervention period. Results: In the pre-intervention period, our clinic show-rate was 207/352 (58.8%) The pilot survey had a total of 43 responses. The most common reason for a missed appointment was 'forgot about the appointment' (45.5%). Reminder phone calls were the preferred intervention (76.74%), which patients' thought might help to keep scheduled appointments. In the intervention period, 283 of the scheduled 378 appointments were completed (74.8) in the lupus clinic. The difference in the show rate before and after the intervention by Pearson's Chi-squared test with Yates continuity correction was statistically significant with a p-value of 0.0062. Conclusion: A simple telephone call reminder significantly improves clinic show rates in an underserved Lupus clinic, which can help improve health parameters in the Lupus population.