Date of Award

Spring 4-10-2024

Document Type

Thesis

Degree Name

Doctor of Nursing Practice (DNP)

First Advisor

Sallie Coke

Second Advisor

Debbie Greene

Third Advisor

Chris Zorn

Abstract

Abstract

The purpose of this DNP clinical project was to conduct a retrospective data analysis on no-show patients at a large, urban, academic oncology clinic to determine those factors that may be contributing to the missed appointment and to suggest ways to improve the process that will benefit the patients and the practice. Data abstraction was performed via chart review for no-show visits for the preceding 6 months from the time of analysis (January 2023 to June 2023). Key information collected included date of missed appointments, age, gender, primary language, race, insurance provider, marital status, new patient visits versus follow-up appointments, zip code, religion, cancer type, and employment status. Descriptive data analyses were performed on the collected information. The total population (N = 2,841) consisted of patients aged 19-89 with a mean age of 59 (SD =14.93) Patients were categorized into low, medium, and high groupings based on number of missed patient visits. Those who only missed one visit were more frequently older, Caucasian, female, and married. Those that missed 2-3 visits were more frequently African American, younger than the less often missed patients but older than more frequently missed, female, and married. Patients who missed 4 or more visits were more frequently male, African American, younger, and single. The significance of employment status and religions was unable to be determined. There was not statistical significance between no-shows and language or payor source. The total cost for all infusion center-associated appointments alone was $862,831.09, and the total estimated cost of all no-show visits for all visit types over 6 months was $1,214,294.18. Budde et al. (2021) observed that nurse navigation has been shown to improve clinic attendance. This author recommends implementation of nurse navigation in the infusion center and lab at this Cancer Center with a job role of contacting higher risk for no-show patients prior to their appointments for confirmation that they know of their appointment and for assessment of any barriers to attending the appointment.

Keywords: no-show, nurse navigation, oncology

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