Factors associated with non-attendance at consultant-led appointments in an Older People’s Mental Health Service: a clinical audit to inform quality improvement
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en
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MENTAL HEALTH, PATIENT COMPLIANCE, OUTPATIENTS, AGED
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Background: Non-attendance (DNA) at outpatient appointments is a significant issue within older adult mental health services, leading to inefficient use of time by clinicians and delayed care for patients. It is already known that older people are more likely to forget about medical appointments, however systems are already in place which aim to remind patients of their appointments. In order to combat not attendance, we need to know more about why some people are slipping through the existing nets.
Aims: This audit aimed to identify patterns amongst those that did not attend consultant-lead appointments within an older adult mental health service by comparing them to patients that did attend. The overall aim is to use this information to develop and implement a change to the current running of the service with the goal of reducing appointment nonattendance.
Methods: Data was collected retrospectively from patients’ electronic health record for all consultant-led appointments over a 6 month period. 29 non-attended appointments were identified and compared with 29 randomly selected attended appointments.
Results: Non-attendance was more common in Memory Assessment Service (MAS) appointments than CMHT appointments. Clinic-based appointments were more likely to be missed than home visits and telephone calls. Initial appointments were more likely to be missed than follow ups. The most common reason for referral amongst those that did not attend was suspected Dementia. High 6-CIT score was a predictor of nonattendance. Absence of NOK contact details at referral and documented communication or mobility difficulties were more prevalent in the DNA group.
Conclusions: Interventions aimed at improving how we identify and target patients that are at risk of not attending appointments and improving how we gather useful information from GPs may reduce rate of DNAs in the future.