Improvement Plan (2)

Opportunity/Aim: Decrease the unkept appointment rate from 30% to 20% Team Leader/Sponsor:
Source	Issue	Improvement	Result
Patient	Patients make appointments and do not keep them Patients face multiple barriers to keeping appointments, i.e. lack of transportation and childcare, work schedules, mental illness and active drug/alcohol use	Appointment Secretary to call all pts one day prior to appointment Check-out clerk educates patients re importance of keeping appointment and calling to cancel and reschedule if they cannot keep it. Provide additional support to patients who miss serial appointments Referral of all patients who regularly miss appointments to Peer Advocate and Social Work team	Difficult to reach patients due to disconnected telephone numbers Despite support system in place, some patients still cannot keep appointment
Provider	Providers have limited appointment availability and get frustrated when patients do not keep appointments. They are unable to monitor patients clinical status without regular laboratory monitoring	Provider to emphasize importance of keeping appointments and regular lab monitoring Provider to review missed appointments with patients who serially miss appointments	Providers more involved with educating patients re importance of visits
System	No system in place to update patient contact information No system in place to contact pts prior to their appointment and to follow-up for missed appointments No system in place to notify provider of missed appointments	Check-in clerk to request updated contact information for every pt. for every visit and update computer system and chart Appointment secretary to call all patient on the day before their appointment All missed appointments documented on progress note for review by provider	Implementation successful but need backup staff to assure system is implemented fully without gaps