Date of Conferral

11-6-2025

Date of Award

November 2025

Degree

Doctor of Nursing Practice (DNP)

School

Nursing

Advisor

Jill Walsh

Abstract

I conducted this Doctor of Nursing Practice (DNP) project to develop an evidence-based clinical practice guideline (CPG) to reduce missed follow-up appointments and improve care continuity in a family medicine outpatient clinic. Missed follow-ups, especially common in underserved populations, compromise safety, delay treatment, and increase costs. The purpose of this doctoral project was to develop and appraise a CPG that integrates evidence-based strategies to improve follow-up procedures, reduce missed appointments, and enhance patient safety and care continuity in an outpatient setting. This project addressed the practice-focused question: Will a CPG around structured follow-up for patient visits in an outpatient clinic be approved by a group of subject matter experts utilizing the Appraisal of Guidelines for Research & Evaluation II (AGREE II) tool? Analytical strategies included a structured literature review using the Johns Hopkins evidence-based practice (JHNEBP) model and expert panel appraisal of guideline quality using the AGREE II instrument. The panel’s aggregated results showed strong ratings across the six domains. Key recommendations included automated text/email/phone reminders 24–48 hours before appointments, use of predictive analytics, integration of follow-up workflows into the electronic health record (EHR), and ongoing training and feedback mechanisms. This project enhances nursing practice through improved care coordination, reduced no-show rates, and effective use of predictive tools to identify at-risk patients. The project also advances health equity by promoting structured follow-up care for vulnerable populations, aligning evidence-based guidelines with stakeholder input to support diversity; inclusion; and safer, more efficient care delivery.

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