Background: Missed appointments at outpatient clinics are a significant problem inherent in local and regional healthcare systems in the United States, as well as globally. The outcome is costly to organizations and burdensome on organizational productivity, the healthcare system, and poor patient outcomes. The use of text message appointment reminders potentially offers a cost-effective and time-efficient strategy to decrease missed appointments, thus, improving the efficiency of outpatient healthcare delivery. Evidence-Based Framework: The organization change at the outpatient community clinic was to implement the use of a text messaging appointment reminder system in an attempt to reduce missed appointment rate. The Health Belief Model and the IOWA Model were used as theory and evidence-based practice model respectively for the development of the project. Method: The objectives of the project were: (1) to impement a text message reminder system to reduce missed appointments; (2) to maintain the standard practice of patient reminders using telephone calls; (3) and to reduce lost revenue from missed appointments. The goal of the project was to reduce the number of missed appointments at the outpatient community clinic. Evaluation was accomplished through comparing missed appointment rate during the text message implementation period with the missed appointment rate during the same period in the previous year. Data was collected using a self-developed data collection tool. The results of the project will be use to demonstrate the impact text messaging has on appointment attendance. Recent literature has provided evidence that text message reminders to patient care are effective in reducing missed appointment rate in outpatient clinics. Findings: The implementation of text messages to remind patients of their healthcare appointment reduced missed appointments to 1.94%, compared to 19.12% during the same time period in the previous year when text messaging was not used. Conclusions/Recommendations: Based on the findings of this quality improvement project, use of a text messaging reminder system is suggested in outpatient settings. Recommendations include: the clinic should consider the use of an automated text message system to help reduce staff workload, burnout and reduce human errors. Areas for future study: extend study to verify the impact of text message reminder system on missed appointments for a longer period of time, compare different populations and missed appointments, financial benefits and costs to the clinic and to the patient. An additional recommendation would be to focus on patient satisfaction rates.
