Does Informing Referring Practices About Visit Non-Compliance Improve Subsequent Show Rates to a Pediatric Cardiology Practice?

Abstract

Background. Missed specialty appointments are common. Consequently, patients may never receive intended sub-specialty care. We predicted that no-show (NS) notification would result in more successful encounters following a NS. Methods. Referring practices were surveyed regarding how NS communication may change patient management. To test the effect of NS notification, two prospective patient groups were evaluated: a non-notification group (Control) and a NS-notification group (Intervention). Patients were tracked seven months to determine rates and time to a successful encounter. Group differences were assessed by either a two sample Z-test for proportions or an independent t-test. Results. The survey indicated that 43.7% of practices routinely receive NS notification from subspecialists. For 69%, NS notification would prompt patient/family contact. Baseline NS rates for the Control group (n = 633) was 10% (n = 67) and for the Intervention group (n = 623) was 13.5% (n = 83, p = 0.1). Rates of eventual successful encounters among NS patients were 28% for the Control group and 11% for the Intervention group (p = 0.21). Mean time to successful encounter was shorter in the Intervention group (Control, 2.9 months +/-2; Intervention, 1.65 months +/- 0.9, p = 0.045). Conclusion. Unlike adult studies, pediatric practitioners likely would intervene if a NS was known. Although fewer patients were seen in the NS notification group, the time to encounter was shorter for the Intervention group compared to Controls. While NS notification may not lead to more successful encounters, enhanced communication to the referring practice may ensure that the most worrisome patients are seen promptly.