Development and Evaluation of Nurse Practitioner- Driven Appointment Reminder Initiative at an Outpatient Mental Health Clinic

No-shows or missed appointments have a negative impact on the effectiveness and efficiency of healthcare facilities. No-shows contribute to high healthcare costs and lost revenue due to underutilization of services, unnecessary disruptions in workflow, increased workload, and scheduling challenges. Mental health clinics report high no-show rates due to factors such as forgetfulness among patients. The purpose of this quality improvement project was to implement a text message patient appointment reminder system to reduce the no-show rate and increase provider knowledge in an outpatient mental health clinic in 15 weeks. The project was guided by the Iowa model of evidence-based practice and Pender’s Health Promotion Model. The project adopted a quasi-experimental design using a pretest and posttest approach. No-show data was collected from the clinic’s electronic health records. A questionnaire was used to collect data on the provider’s knowledge of no-shows and their effect on the organization. The data was analyzed using descriptive statistics and a paired t-test. The no-show rate reduced from 1.40 (SD=0.492) to 1.14 (0.348) post-intervention. The appointment attendance rate improved from 60% to 86%, reducing the no-show rate by 14%. The reduction in the no-show rate was statistically significant (p=.000). An improvement in provider knowledge of no-shows and their impact on the clinic was noted post-intervention. Health administrators in mental health clinics should adopt text message reminder systems to reduce missed appointments, improve patients’ mental health, and increase revenue.