Strategies to reduce 'failure to attend' rates in specialist clinics: an implementation framework

Area of Science:

• Healthcare Management
• Patient Flow Optimization
• Clinical Risk Reduction

Background:

• High rates of patients failing to attend specialist clinic appointments lead to extended waiting times.
• Deferred care due to missed appointments poses significant clinical risks.

Purpose of the Study:

• To investigate the drivers of patient failure to attend (FTA) specialist clinics.
• To evaluate interventions aimed at reducing FTA rates and improving clinic capacity.

Main Methods:

• A mixed-methods approach combining quantitative analysis of FTA risk factors and qualitative interviews with patients.
• Development and testing of four interventions: increased SMS frequency, real-time booking, behavioral nudges in SMS, and targeted communication for high-risk patients.

Main Results:

• New patients and those with prior no-shows were identified as high-risk groups for FTA.
• Qualitative findings informed the development of interventions that successfully reduced FTA rates.
• Interventions achieved a net reduction in FTA ranging from 10.8% to 54.9%.

Conclusions:

• An integrated strategy effectively reduces specialist clinic no-show rates.
• Reducing FTA improves clinic efficiency and mitigates risks associated with delayed patient care.