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No-Show Phone Script to Improve Appointment Keeping

June 22, 2020
Author: Orange County Health Care Agency

Center for Quality Improvement and Innovation (CQII)

Intervention

Script developed and used by front office staff to follow-up with no-shows by phone to assess reasons for missed appointments and respond accordingly (e.g., mail bus pass to those not showing due to transportation challenges), with subsequent improvements seen in viral suppression rates among MSM of color. 

Change Ideas

  • Phone script was developed based on no-show list in EMR.
  • In addition to following up to reschedule, phone script included an inquiry on possible transportation barriers.
  • Inform those patients who are eligible for transportation assistance through outreach.
  • Provided transportation assistance through bus passes if necessary, after follow up no-show call.
  • Case management referral not needed.

Summary

There is some evidence that shows that follow-up phone calls for missed appointments reduce no-show rates, which has been proven along with reminder phone calls.1 A no-show script that identified barriers to keeping appointments was developed for front office clerical staff to follow up with no-show patients 15 minutes after the appointment time to reschedule. This intervention was carried out due to no-shows being identified from a Cause and Effect Diagram as a cause of poor viral suppression among MSM of color. The phone script included asking about possible transportation barriers for patients. If transportation was found to be a barrier, a bus pass was mailed to the patients. Phone script was developed based on no-show list in EMR. This intervention helped streamline the no-show follow-up process. Among the staff making the phone calls were the eligibility staff, since they tend to have better responses from patients concerned about maintaining Ryan White HIV/AIDS Program benefits such as access to medical, food, or housing services. Those who were eligible to receive transportation assistance were informed during outreach activities. In the clinic, the overall no-show rate decreased by 2% during this intervention. In a 6-month period during the intervention, there was a 28.6% increase in patients attending their next follow-up appointment. Viral suppression among the youth subpopulation has increased from 87% in 2018 to 90.9% currently.

1 Adams JA, Whiteman K, McGraw S. Reducing Missed Appointments for Patients With HIV. Journal of Nursing Care Quality. 2019. 35(2):165–170.

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