Multimodal Interventions to Assist in Reducing No Show Rates in an Outpatient Primary Care Setting

This Doctor of Nursing Practice (DNP) incorporated a Clinical Practice Guideline (CPG) approach to address a practice issue of increased no show rates of patients scheduled for follow-up appointments in an adult outpatient primary care setting. Missed appointments symbolize a long-standing practice problem in ambulatory care, exacerbating challenges like healthcare expenses, fragmented care, inefficient resource utilization, and delayed treatment often resulting in negative patient outcomes. The project’s purpose was to develop an evidence-based CPG with integrated multimodal patient outreach strategies, including patient portal, text messaging, transportation support, and live reminder calls within Electronic Health Record (EHR) system to prevent and/or limit appointment no-shows. The Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument was used to guide the development and appraisal of the CPG. The practice-focused question guiding this project sought to address whether the development of an EHR-integrated clinical practice guideline with multimodal outreach interventions aimed at reducing no-show rates in adult patients scheduled for follow-up visits in a primary care setting, would be approved by an expert panel for use in the practice. The doctoral project incorporated the highest evidencebased literature that was appraised using the Johns Hopkins Evidence-Based Practice (JHNEBP) Model. Data analysis was conducted using descriptive statistics. The analysis revealed that the expert panelists rated the guideline quality as high and approved it for use in practice. The CPG has the potential to enhance nursing workflow efficiency, enhance continuity of care, promote workplace diversity, and enhance care equity, which can positively impact social change.