title: Non-attendance at the colorectal clinic: a prospective audit.
abstract: BACKGROUND
  Non-attendance in the out-patient department has financial costs for the NHS and clinical implications to the non-attender and those awaiting an appointment. The aim of this audit was to quantify the percentage of non-attenders at colorectal clinics in a UK teaching hospital, assess which factors affected attendance, establish why individuals fail to attend and to implement appropriate change.
  
  
  METHODS
  The number of 'did-not-attend' patients was recorded initially for 686 appointments. Non-attenders were contacted by post or telephone to ask why this was so. The study was then repeated following telephone reminders to 391 patients due to attend clinic. The 'did-not-attend' rates in the two limbs of the completed audit cycle were then compared.
  
  
  RESULTS
  The initial study revealed a 'did-not-attend' rate of 21%, with significantly more males than females failing to attend (males, 28.6%; females, 16.9%; P = 0.001). The 'did-not-attend' rate was not significantly affected by the day of the week, time of appointment or by the weather. There were 51.7% responses to either the postal or telephone questionnaire regarding non-attendance. Of these, 27.7% did not receive an appointment letter or received it after the appointment. Hospital administration problems were cited as accounting for 34.2% of 'did-not-attends'. In the post-intervention limb, 87 patients (22%) replied to the reminder telephone call, of whom 9 (10%) cancelled their appointment and 78 (90%) confirmed that they would attend. The 'did-not-attend' rate fell to 19.7% although this was not a significant reduction.
  
  
  CONCLUSIONS
  Telephoning patients before their appointments is labour intensive and did not significantly improve the 'did-not-attend' rate. Although hospital administration errors account for a significant number of the 'did-not-attends', patients also have a responsibility to notify the hospital if they are unable to attend.
authors.affiliation: Department of Colorectal Surgery, St Thomas' Hospital, London, UK. lcorfield@doctors.org.uk
authors.forename: Lorraine
authors.initials: L
authors.lastname: Corfield
authors.forename: Alexis
authors.initials: A
authors.lastname: Schizas
authors.forename: A
authors.initials: A
authors.lastname: Noorani
authors.forename: Andrew
authors.initials: A
authors.lastname: Williams
mesh_terms: D000556:Ambulatory Surgical Procedures / Q000523:psychology / Q000706:statistics & numerical data*; D001071:Appointments and Schedules; D003107:Colorectal Surgery / Q000523:psychology / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008485:Medical Audit; D010044:Outpatient Clinics, Hospital / Q000706:statistics & numerical data*; D010349:Patient Compliance / Q000523:psychology / Q000706:statistics & numerical data*; D011446:Prospective Studies; D012017:Referral and Consultation; D017010:Reminder Systems / Q000706:statistics & numerical data; D012737:Sex Factors; D011795:Surveys and Questionnaires; D013689:Telephone; D016312:Treatment Refusal / Q000523:psychology / Q000706:statistics & numerical data*