1. Improving Attendance in the Pediatric Weight Management Clinic
Claudia Fox, MD, MPH
MMRB presentation

2. Disclosure
Funding: none

3. Quality Gap Childhood obesity is a chronic medical condition
Obesity treatment requires regular contact with treatment team
Patient attendance at appointments is poor
Cancellations
No-shows
Consequences of poor attendance include poor patient outcomes and limited clinic access

4. Quality Gap
Identify patient no-show rate and test strategies to reduce no show rate

5. AIM
“Our aim is to reduce the no-show rate of patients attending the Pediatric Weight Management Clinic by 20% by September 1, 2018.” Measures: - Clinic No-show rate (outcome – process) - # of patients who no-showed/tot # scheduled

6. Interventions Reminder phone calls Informing patient of no-show policy
Students call all new and f/u patients on Dr. Fox’s schedule for month of 10/2016
Up to 3 attempts
Left message on 3rd attempt
Outcome measured 11/2016
Informing patient of no-show policy
No-show policy: after 2 no shows for new appt and 3 for a f/u appt, pt is asked to seek care elsewhere
Scheduler verbally discusses this policy with all patients in month of 5/2018
Outcome measured 8/2018

7. Outcomes – No-show rate
Cycle 1
Before intervention 21% (16/75)
After intervention 21% (18/86)
Cycle 2
Before intervention 17% (11/59)
After intervention 15% (11/72)

8. Spread, Sustain, Impact We stopped student led reminder calls
We continue to remind patients of no-show policy at time of making appointments
This activity has not made significant impact on my individual practice as there continues to be unscheduled slots in schedule
Surprised by relatively low no-show rates
Next gap to address is late cancellations