Document Type

Dissertation

Publication Title

Reducing Appointment No-Shows in an Occupational Medicine Clinic: A Quality Improvement Project

Abstract

Abstract

Background: Appointment no-shows in occupational medicine delay recovery, disrupt workers’ compensation processes, and undermine employer trust. A South Texas clinic reported an average 11% no-show rate over 16 months—above the ≤8% benchmark—resulting in an estimated $379,406 in lost revenue. Contributing factors included inconsistent reminder practices, unverified contact information, and language barriers within a predominantly Spanish-speaking population.

Objective/Project Aim: This project aimed to reduce no-shows to ≤8% by implementing a structured, bilingual, multimodal reminder system that improved patient adherence and operational efficiency without increasing staff workload.

Methods: Guided by the “Getting To Outcomes” 10-Step framework, interventions included automated text reminders, manual follow-up calls, and bilingual educational materials. Data from CareVision reports, call logs, and staff surveys were evaluated through iterative Plan-Do-Study-Act cycles.

Results: Within three months, the no-show rate decreased from 11% to 3.6%. Automated text reminders reached all patients in their preferred language, and manual calls engaged 100% of non-responders. Staff satisfaction reached 87%, with minimal added workload, demonstrating feasibility and seamless workflow integration.

Conclusion and Nursing Implications: This project highlights the critical role of nurses in leading evidence-based quality improvement through structured, bilingual communication strategies that strengthen adherence, streamline operations, and improve outcomes.

Key Words: Missed visits; occupational medicine; multimodal reminder system; bilingual communication

Publication Date

2025

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