Reduction of No-Show Rate for New Patients in a Pediatric Neurology Clinic.

BACKGROUND: The rate of patients not keeping their appointments at our children's hospital outpatient pediatric neurology clinic (no-shows) was high. We conducted a quality improvement project to reduce no-show rates and improve operational efficiency. Specifically, we aimed to decrease the new patient no-show mean rate from 7% to 4% at the main campus and from 17% to 12% at the south campus. METHODS: After reviewing the previous literature on this topic and institutional data, we used the simplified failure mode and effects analysis (sFMEA) to identify the key drivers. Of the patients at the main campus who failed to keep their appointment, 84% had not confirmed their appointment. Errors in inpatient/family contact information, limited use of the electronic patient portal, and miscommunication were other key drivers identified. Three Plan-Do-Study-Act (PDSA) cycles were completed over seven months. The key interventions we implemented were bidirectional text triage, telephone reminders, and promoting the use of the electronic patient portal. A run chart was used to assess the results of these interventions. RESULTS: A statistically significant shift was noted in the run chart for the median rate of no-shows, which declined from 7% to 4% at the main campus and 17% to 10% at the south campus. CONCLUSION: We were able to successfully reduce no-shows among new patients in the neurology clinic. The limitations of our study include unknown external factors, the potential impact of COVID-19, and the brief length of the study.

Foreclosures, Evictions & Utility Cutoffs: The Fair Housing Impact of COVID-19 on Black Communities

From the Introduction: This report by the Thurgood Marshall Institute at the NAACP [National Association for the Advancement of Colored People] Legal Defense and Educational Fund, Inc. ('LDF') focuses primarily on the fair housing impacts of COVID-19 [coronavirus disease 2019] on Black communities. To provide context for the housing challenges that Black homeowners disproportionately have experienced, the first section discusses the 2008 foreclosure crisis--caused, in part, by discriminatory lending practices that preyed on Black borrowers--and the losses that Black households continue to suffer as a result. The second section of our report discusses the current eviction epidemic plaguing the United States that is disproportionately impacting Black renters. Next, we provide details on recent legislative measures enacted to protect home-owners and renters during the pandemic. We conclude with several policy recommendations--including additional foreclosure, eviction, and water shutoff moratoriums--that federal, state, and local officials should implement to safeguard the communities most likely to be disproportionately impacted by the current pandemic.COVID-19 (Disease);Discrimination in housing;Eviction