Reasons for non-attendance: audit findings from a nurse-led clinic

Abstract

BACKGROUND AND CONTEXT: Evidence has shown that non-attendance at clinics occurs for a variety of reasons and impacts negatively on client outcomes and effective use of clinic resources. This paper reports an audit of non-attendance at Care Plus and diabetes clinics undertaken between October 2007 and October 2008, in a large general practice in the Wellington region. ASSESSMENT OF PROBLEM: A retrospective and prospective audit of the non-attendance rate at nurse-led wellness clinics was completed using the Query Builder function in Medtech32, collecting data from 142 people who did not attend a scheduled appointment. RESULTS: Thirty-three people were unable to be contacted about their reason for not attending. Of those contacted, 68 did not attend because they were unaware of the appointment, confused regarding the appointment time, or simply forgot. Eighty-four people were aged between 18 and 65 years, yet of those contacted, only four cited work had prevented their attendance at the clinic. Difficulty with transport was reported by only two people. STRATEGIES FOR IMPROVEMENT: The audit highlighted the importance of administration processes for scheduling routine appointments and reminding patients about appointments. It provided evidence that administrative support for nurse-led clinics is necessary. LESSONS: Involvement in clinical audit was a new experience for many of the staff and the usefulness of the findings led to more positive views about how audit can be used. The importance of appropriate administrative support was highlighted. Lessons learned for future audits included the importance of a complete data set and consistent use of codes for data entry. KEYWORDS: Audit; primary care; non-attendance