ABSTRACT
@#No-show or non-attendance at outpatient appointments are one of the most challenging operational issues in health care clinics, including dietetics outpatient clinics. No-show has a negative impact on the efficiency and effectiveness of delivery of outpatient care in a hospital setting. This can negatively affect the patient’s short term and long-term wellbeing due to missed opportunity to address the patient’s nutrition issue in a timely manner. This study aims to investigate the reasons for no-show and thus to reduce the no-show rate in diet clinic from baseline of 40.7% to standard of less than 25%. The initial phase of the study was conducted from June to September 2017 at Hospital Sultan Ismail’s diet clinic. No-show cases were identified using system data. No-show patients or guardian of no-show patients were contacted to record the reason for missing the appointments. Descriptive analysis was used to analyze the results. Strategy for change was planned and implemented to target the major reason for no-show. The pre-remedial phase result shows a no-show rate of 40.7%. A total of 102 patients were contacted (34%, n=102) to identify their reason of non-attendance to diet clinic. Paediatric patients aged 1 to 12 year-old contributed the highest percentage of no-show (37.3%, n=38). The major reasons identified for no-show are forgetting and remembered wrong appointment date (35.3%, n=36), followed by ill or admitted to ward (13.7%, n=14) and others (12.7%, n=13) such as personal issues and school examination. Remedial measure using Short Message Service (MySMS) resulted in a reduction of no-show rate to 22.2% which achieved our standard of less than 25% (p<0.05). Automated reminder using Short Message System (MySMS) is found to be effective in reducing no-show rate. Periodic audit is needed to ensure continuous effectiveness of remedial measure. Further studies need to be conducted in weighing the cost effectiveness of this method for long term run.