Non-Attendance at Paediatric Outpatient Appointments in Brighton: a Quality Improvement Project
Biggart R, Hallows MR*
Royal Alexandra Children's Hospital, Brighton, UK *
Background
It had been noted that there are a considerable number of

non-attendances at paediatric outpatient appointments

in Brighton despite appointment letters and SMS reminders sent a week before.

Aim


To determine the reasons why families do not attend their appointments with a view to change the service provided to achieve better patient outcomes and to maximise NHS (National Health Service) financial resources.

Method


Over a 2 month period the families of the children who did not attend (DNA) were telephoned and were asked a series of predetermined standardised questions.

Results


Between the 19th November- 14th December 2012, there were 107 DNAs whilst between 14th January- 15th February 2013 there were 170. In this second month the number of families who were registered for SMS messaging was also recorded. 17.6% were not registered, whilst 17.1% of those whom had given consent had no mobile-phone number on record. The main reasons for not attending, according to those who were contacted across the 2 months, are forgetfulness (42.4%), the hospital not informing families of the appointment (20.2%), the hospital not recording that parents had rescheduled (15.1%), that parents were too busy to take their child (11.1%), that the child was too unwell to attend (6.1%) and other reasons (5.1%). Nearly 47% of families did not answer when called, but correct contact information is an issue as 17.7% of the DNAs had an incorrect number recorded or no number recorded at all.

Conclusion


The hospital must maximise its resources to remind parents of attendance. The results of the audit suggest that change the SMS reminder to 2 days before the appointment, encourage parents to register for SMS reminders and NHS staff check that contact details are correct. Finally the accuracy of informing patients of appointments and recording alterations must be improved.
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