Date of Conferral

4-22-2025

Date of Award

April 2025

Degree

Doctor of Nursing Practice (DNP)

School

Nursing

Advisor

Barbara Niedz

Abstract

This doctor of nursing practice (DNP) project presents an organizational quality improvement initiative implementing a text message reminder system to decrease appointment no-show rates in the outpatient mental health clinic. The project was developed based on the high rate of appointment no-shows at the DNP project site. Appointment no-shows are costly to both clinics and patients. Clinics experience decreased revenue and efficiency, and patient outcomes can be compromised. The project evaluated whether text message reminders sent 24 hours before a scheduled appointment time decreased no-show rates by at least 10%. Preimplementation data were collected for months October, November, and December, 2023, and postimplementation data were collected for February, March, and April, 2024. Chi-square analysis showed a decrease in appointment no-shows by 14.81% in postimplementation months. Analysis also showed statistical significance X2 = 36.814 (2, p < .001). Based on the results of this project, it is recommended that the clinic continue using the text message reminder system. However, it is also recommended that they implement the intervention sooner than 24 hours before the scheduled appointment. This allows for backfilling appointment slots. The project successfully identified a method to decrease outpatient no-show rates. However, some changes must be made to the project in the future to further improve patient compliance, clinic efficiency, and overall health outcomes. This project promotes positive social change by providing equitable access to appointment scheduling assuring a benefit of continuing treatment. As access to care is often hampered by social determinants, this provides a positive social change benefit that is useful for addressing the needs of a diverse patient population.

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