Optimizing Laboratory Appointment Adherence Among Patients Prescribed Psychoactive Medications

PURPOSE The purpose of this scholarly project was to implement a standardized nurse-driven phone call reminder protocol to improve adherence to scheduled laboratory appointments among patients prescribed psychoactive medications requiring bloodwork. This protocol is aimed to increase appointment adherence and reduce no-show rates within the clinic. BACKGROUND The project was implemented within a small outpatient community-based clinic in Round Rock, Texas which provides mental health services. The clinic experienced high no-show rates for scheduled laboratory appointments among patients prescribed psychoactive medications. Monitoring these patients is essential to ensure medication safety and prevent potential adverse effects. METHODOLOGY The six-week quality improvement project (Sept–Nov 2024) included 77 patients prescribed psychoactive medications with scheduled laboratory appointments. Trained nurses made reminder calls using a standardized script within 72 hours of appointments. Adherence was tracked and anonymous patient satisfaction surveys were completed with feedback informing future improvements through the Plan-Do-Study-Act framework. RESULTS Prior to implementation, the no-show rate was 33% (21 of 63 patients) over a six-week period. In a separate six-week period following implementation, the rate declined to 19% (15 of 77 patients). Patient satisfaction was not assessed prior to project implementation. Following implementation, patient satisfaction was measured using a voluntary, anonymous survey with Likert-scale responses. No show rates were collected through electronic health records and analyzed using descriptive statistics. Of the 77 patients, 29 completed the voluntary, anonymous patient satisfaction survey, with 24 of those respondents selecting “strongly agree” regarding their overall satisfaction. IMPLICATIONS The nurse-driven phone call reminder protocol improved adherence to scheduled laboratory appointments for patients prescribed psychoactive medications. Improved adherence supports safer medication management and potential early detection of adverse effects. This cost-effective intervention improved clinic efficiency and supported safer medication management, with potential for adoption in similar outpatient settings and implications for other institutions.