Reducing non-attendance at outpatient clinics.
Outpatient non-attendance is a common source of inefficiency in a health service, wasting time and resources and potentially lengthening waiting lists. A prospective audit of plastic surgery outpatient clinics was conducted during the six months from January to June 1997, to determine the clinical and demographic profile of non-attenders. Of 6095 appointments 16% were not kept. Using the demographic information, we changed our follow-up guidelines to reflect risk factors for multiple non-attendances, and a self-referral clinic was introduced to replace routine follow-up for high risk non-attenders. After these changes, a second audit in the same six months of 1998 revealed a non-attendance rate of 11%--i.e. 30% lower than before. Many follow-up appointments are sent inappropriately to patients who do not want further attention. This study, indicating how risk factor analysis can identify a group of patients who are unlikely to attend again after one missed appointment, may be a useful model for the reduction of outpatient non-attendance in other specialties.
Department of Plastic and Reconstructive Surgery, Royal Devon and Exeter Hospital.
C A
CA
Stone
J H
JH
Palmer
P J
PJ
Saxby
V S
VS
Devaraj
D001071:Appointments and Schedules; D004739:England; D006801:Humans; D008485:Medical Audit; D010044:Outpatient Clinics, Hospital / Q000458:organization & administration / Q000706:statistics & numerical data*; D011446:Prospective Studies; D012307:Risk Factors; D013518:Surgery, Plastic / Q000458:organization & administration / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D016312:Treatment Refusal / Q000706:statistics & numerical data*