What is the issue?
In the East Orange Hospital Clinic (Carewell Health Medical Center), most beneficiaries represent the impoverished population, and the problem of skipping the follow-up appointments has recently occurred. More than 25% of patients did not attend the planned visit with their doctor during the last month, and the attendance keeps decreasing. The problem of skipped follow-ups is significant, and multiple reasons cause patients to non-attend their doctor after the initial visit. One of such factors is the socio-economic status of beneficiaries as it influences their priorities and healthcare insurance services affordability (Dantas et al., 2018). Employment and family obligations, costly transportation, and long clinic wait times prevent impoverished populations’ representatives from re-attending a hospital (Ofei-Dodoo et al., 2019). The issue is also related to the clinical practice as the patients lack education about the importance of the follow-up visits, cannot communicate their needs, or do not receive additional reminders.
Why the issue is urgent?
The problem is urgent because the growing number of skipped follow-up visits signals lower satisfaction with the quality of the services. The lack of additional examination negatively influences the initial treatment outcomes and can worsen patients’ conditions. Consequently, they will have to return to the hospital, and the costs for it would be much higher than for attending a follow-up visit on time. It will result in a financial burden not only for the impoverished clients but also for the organization that will have to organize services and human resources for treatment (Dantas et al., 2018). The practical intervention to influence the beneficiaries’ behavior should be implemented urgently to avoid negative consequences and help the patients develop the correct perception of hospital appointments’ attendance.
Who should be involved?
The project to influence the impoverished population’s behavior must address the reasons for their decision-making, and that goal can be achieved through updates in doctors’, nurses’, and administrators’ actions. Indeed, physicians can improve patient education through teaching how crucial it is to attend the appointment; administration can develop reminder practices (Ofei-Dodoo et al., 2019). Nursing practitioners can also adjust their communication to tailor the importance of follow-up visits and ensure that the client understands. Diverse activities are necessary to be performed by several practitioners simultaneously to achieve sustainable results. The quality improvement team, preceptor, and leaders must also be involved to control and assess the intervention’s effectiveness.
What are the intervention objectives?
The two key objectives were developed be based on the research about the population and the practical interventions that can be implemented urgently. The number of missed appointments should decrease by at least 10% in 8 weeks to consider the activities performed to address the issue effectively. Then, the awareness of the follow-up visits importance must be improved through each patient’s education within the next two months. Although this objective is difficult to measure, it is assumed that communicating on the topic with each client will influence their behavior and decision-making (Rew et al., 2020). In 8 weeks from the project’s implementation, the feedback must be gathered to identify the challenges and adjust the strategy to address them.
What is the intervention plan?
Diverse activities are necessary to be performed by several professionals simultaneously to achieve sustainable results, and each participant must perform their tasks while interacting with clients. Indeed, physicians include patient education about the importance of follow-up appointments and explain the consequences of skipping them based on patients’ individual health conditions (Dang et al., 2021). Administrators develop extended reminder practices, such as reaching through messengers and emails. Nursing practitioners adjust their communication to tailor the importance of follow-up visits and ensure that the client understands. Participants are also encouraged to take notes about patients’ reactions to the topic, their understanding of hospital attendance, and important considerations about the services.
How to evaluate the effectiveness?
The outcome is the decrease of the skipped follow-up visits by the impoverished populations, and it can be calculated through attendance tracking. The hospital operates through an electronic record system, and data to analyze would be retrieved from there. Timeframe to realize the initiative and achieve notable results depends on the number of follow-up visits assigned by physicians to their impoverished patients. The average period, such as two months, can be chosen for checking if the percentage of missed appointments changed. Furthermore, physicians and nursing practitioners are encouraged to collect patient feedback and take notes about their perception of the follow-up visits’ costs, aims, and outcomes (Rew et al., 2020). After the first two months of the intervention, the efficiency will be evaluated, and the knowledge of clients’ opinions will be the foundation for further change in practice.
References
Dang, D., Dearholt, S. L., Bissett, K., Ascenzi, J., & Whalen, M. (2021). Johns Hopkins evidence-based practice for nurses and healthcare professionals: Model and guidelines (4th ed.). Sigma Theta Tau International.
Dantas, L. F., Fleck, J. L., Oliveira, F. L. C., & Hamacher, S. (2018). No- shows in appointment scheduling–a systematic literature review. Health Policy, 122(4), 412-421. Web.
Ofei-Dodoo, S., Kellerman, R., Hartpence, C., Mills, K., & Manlove, E. (2019). Why patients miss scheduled outpatient appointments at urban academic residency clinics: A qualitative evaluation. Kansas Journal of Medicine, 12(3), 57. Web.
Rew, L., Cauvin, S., Cengiz, A., Pretorius, K., & Johnson, K. (2020). Application of project management tools and techniques to support nursing intervention research. Nursing Outlook, 68(4), 396-405. Web.