Noncompliance with Follow-Up Visits in Primary Care

Noncompliance with Follow-Up Visits in Primary Care by Amanda Michelle Northern MS, Walden University, 2014 BS, Grand Canyon University, 2011 Project Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Nursing Practice Walden University February 2019 Abstract No-show appointments, also referred to as missed appointments, occur 23% to 34% annually in general practice care settings. Missed appointments can lead to reduction in appointment availability, decrease in provider/staff productivity, patient/provider discordance, disruption in continuity of care, and reduced quality of care. There is a gap in the nursing literature regarding effective interventions to reduce missed appointments. The purpose of this quality improvement, secondary analysis project was to determine whether implementation of an evidence-based no-show, nurse-led intervention would reduce missed appointment rates in a family medicine practice. The health belief model and the plan, do, study, act model guided this no-show project. Convenience sampled, password-secured quantitative data from nurse practitioner schedules were analyzed using a check-sheet tool and spreadsheet software. Data showed that after implementation of the evidence-based, nurse-led interventions, there was a reduction of no-shows with a decline from 23.5% in September and November 2017 to 17% in September and November 2018. Results of this no-show project might promote positive social change by increasing awareness of evidence-based interventions that are effective for reducing missed appointments in primary care practices.No-show appointments, also referred to as missed appointments, occur 23% to 34% annually in general practice care settings. Missed appointments can lead to reduction in appointment availability, decrease in provider/staff productivity, patient/provider discordance, disruption in continuity of care, and reduced quality of care. There is a gap in the nursing literature regarding effective interventions to reduce missed appointments. The purpose of this quality improvement, secondary analysis project was to determine whether implementation of an evidence-based no-show, nurse-led intervention would reduce missed appointment rates in a family medicine practice. The health belief model and the plan, do, study, act model guided this no-show project. Convenience sampled, password-secured quantitative data from nurse practitioner schedules were analyzed using a check-sheet tool and spreadsheet software. Data showed that after implementation of the evidence-based, nurse-led interventions, there was a reduction of no-shows with a decline from 23.5% in September and November 2017 to 17% in September and November 2018. Results of this no-show project might promote positive social change by increasing awareness of evidence-based interventions that are effective for reducing missed appointments in primary care practices. Noncompliance with Follow-Up Visits in Primary Care by Amanda Michelle Northern MS, Walden University, 2014 BS, Grand Canyon University, 2011 Project Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Nursing Practice Walden University February 2019 Dedication I dedicate this project to the family. To my love and best friend, Mark, thank you for all the support you gave me throughout this stressful journey. Thank you for understanding and making sure I had uninterrupted time and space to work on my project. Thank you for having patience with me especially when I would say “hold on I am almost done with this section. ” Mark, I love you! I want to say thank you to my children (Christopher, Chase, Hailey, and Hannah) for being there when I needed them. Thank you for supporting me while I worked towards my dream of obtaining my DNP. Hailey and Hannah thank you for the constant reminder “Once you start something you can never quit. ” To my parents, Jim and Sharon Jacobs and my wonderful in-laws George and Sharon Northern, thank you for your support throughout this journey. Thank you for listening to all of my whining when I had to re-write the projects sections over and over again. Thank you all very much! With lots of love, Amanda Northern, MSN, DNP, AGNP-C Acknowledgments Many thanks to all of my preceptors and instructors throughout this DNP project. I would like to give a special shout out to Dr. Hull. Because of you I am a much better writer and confident scholar. Thank you for your guidance and support. You will always have a special place in my HEART! I would like to say thank you to my exceptional committee, Dr. Hayden and Dr. Rogers. Thank you for taking your time and giving your expertise while reviewing my project drafts. My immeasurable thank you for keeping my oral presentations simple, non-judgmental, and as stress-free as possible so I could present my project. I would not have become a DNP without you, Dr. Hull, Dr. Hayden, and Dr. Rogers!