Recommended Citation
McAllister K, Lim N, Kuster-Kosmoski K, Taylor-Coleman K, Sullivan Vedder L. Improving the No-show Rate at the Sinai Family Care Center. Presented at Scientific Day; May 20, 2026; Milwaukee, WI.
Abstract
Background/Significance:
Patient no-show (NS) rates in residency-based primary care clinics are a common problem. Adverse effects include disruption in continuity of care, inefficiency, reduced productivity, delayed care, increased ED visits, and negative impact on resident learning. Studies examining approaches to reducing NS rates in the primary care setting have been conducted, but the best approach remains unclear and is likely highly dependent on unique clinic characteristics. At the Aurora Sinai Family Care Center (FCC) clinic, the overall NS rate was 27% in 2024. Currently, all FCC patients receive automated call reminders two days before a scheduled appointment. This project implemented an additional direct phone call reminder targeted to patients with historically high NS rates.
Purpose:
To evaluate the relationship between targeted direct visit reminder calls and subsequent appointment attendance outcomes.
Methods:
For each FCC clinic day over a 3-month period, direct reminder calls were made to 10 patients identified as having the highest historical NS rates two days prior to scheduled appointments. Call outcome (patient reached, left message, unable to reach) was documented. EMR was reviewed to determine appointment outcomes (show, NS, other). Descriptive and chi square statistics were used to calculate associations between call and appointment outcomes.
Results:
A total of 784 appointments with documented pre-visit targeted direct phone call outreach had a NS rate of 33.8% (265/784). Of the patients reached by phone, 55.9% (212/379) attended their appointment, compared with 44.5% (109/245) when a message was left and 36.9% (59/160) when unable to be reached. Patients unable to be reached had NS rates substantially higher than the overall average (53.1% vs 33.8%), whereas patients who were reached had NS rates below the overall average (22.7%). Differences in attendance counts and NS rates are due to the inclusion of “other” in appointment outcomes (e.g. cancellation, rescheduling). A chi-square test demonstrated a statistically significant association between call outcome and appointment outcome (χ2(4) = 50.9, p < 0.001).
Conclusion:
Targeted direct call reminders to patients with historically high NS rates improved visit attendance when patients were able to be reached. Further cost/benefit analysis of expanding this approach given personnel requirements is needed. Future areas for investigation may include targeting visit types with higher NS rates such as well-child visits.
Presentation Notes
Presented at Scientific Day; May 20, 2026; Milwaukee, WI.
Full Text of Presentation
wf_yes
Document Type
Oral/Podium Presentation
Improving the No-show Rate at the Sinai Family Care Center
Background/Significance:
Patient no-show (NS) rates in residency-based primary care clinics are a common problem. Adverse effects include disruption in continuity of care, inefficiency, reduced productivity, delayed care, increased ED visits, and negative impact on resident learning. Studies examining approaches to reducing NS rates in the primary care setting have been conducted, but the best approach remains unclear and is likely highly dependent on unique clinic characteristics. At the Aurora Sinai Family Care Center (FCC) clinic, the overall NS rate was 27% in 2024. Currently, all FCC patients receive automated call reminders two days before a scheduled appointment. This project implemented an additional direct phone call reminder targeted to patients with historically high NS rates.
Purpose:
To evaluate the relationship between targeted direct visit reminder calls and subsequent appointment attendance outcomes.
Methods:
For each FCC clinic day over a 3-month period, direct reminder calls were made to 10 patients identified as having the highest historical NS rates two days prior to scheduled appointments. Call outcome (patient reached, left message, unable to reach) was documented. EMR was reviewed to determine appointment outcomes (show, NS, other). Descriptive and chi square statistics were used to calculate associations between call and appointment outcomes.
Results:
A total of 784 appointments with documented pre-visit targeted direct phone call outreach had a NS rate of 33.8% (265/784). Of the patients reached by phone, 55.9% (212/379) attended their appointment, compared with 44.5% (109/245) when a message was left and 36.9% (59/160) when unable to be reached. Patients unable to be reached had NS rates substantially higher than the overall average (53.1% vs 33.8%), whereas patients who were reached had NS rates below the overall average (22.7%). Differences in attendance counts and NS rates are due to the inclusion of “other” in appointment outcomes (e.g. cancellation, rescheduling). A chi-square test demonstrated a statistically significant association between call outcome and appointment outcome (χ2(4) = 50.9, p < 0.001).
Conclusion:
Targeted direct call reminders to patients with historically high NS rates improved visit attendance when patients were able to be reached. Further cost/benefit analysis of expanding this approach given personnel requirements is needed. Future areas for investigation may include targeting visit types with higher NS rates such as well-child visits.
Affiliations
Aurora Sinai Medical Center, Aurora UW Medical Group