A prospective audit examining non-attendance at a surgical outpatients clinic in Mater Dei, Hospital, Malta, after the introduction of a text-messaging reminder system

Abstract

Non-attendance rates at hospital outpatients clinics has always proved to be a serious problem. Missed appointments cause delays in patient management, impacting patient outcomes. Mater Dei Hospital introduced a text-messaging reminder system in July 2017 in an attempt to reduce non-attendance rates and this study assesses the efficacy of this system. Four surgical outpatients clinics were observed over a period of one month and the total number of appointments documented. Non-attenders were contacted via a telephone call and asked to explain their non-attendance as well as asked if they had received a text-message reminding them of their appointment. Out of a total of 227 appointments (205 females, 22 males), 49 patients did not turn up, representing a 22% non-attendance rate. Out of these 49 patients, 41 answered their phone and were interviewed for this study. The rest were not reached because a contact number was not in their physical and electronic records (2 patients) or they did not answer their phone at all (6 patients). Out of the 41 contacted, 39% claimed they did not receive a text message reminding them about their appointment whilst acknowledging that they all have a functional mobile phone and they know how to receive and read a text message.

This study shows that non-attendance rates of 30% decreased by 27% to 22% after the introduction of text-messaging. It is hoped that this system will further decrease not attendance rates if more patients have a registered mobile phone number in the hospital electronic records system.