Story of Measurable Improvement in Public Health

Name of Health Department/Agency:	City of Portland Public Health Division
State:	ME
Contact Name:	Toho Soma
Contact Information:	tsoma@portlandmaine.gov
Date Added:	6/26/2011
Program/Topic Area:	Clinic show rates
QI techniques/tools:	Fishbone Diagram,Flowchart,Pareto Chart,Prioritization Matrix,Root Cause Analysis, Chi-sqaure test
Description of the process and intervention:	The goal of the effort was to reduce the no-show rate among HIV Positive Health Care patients from 22% to 11%. Root cause analysis revealed that patients were not showing up to appointments because, due to incorrect contact information, they did not receive reminder calls. The improvement theory guiding the effort was that if patient phone numbers were updated and maintained, then the no-show rate will decrease. The intervention required patients to update their contact information upon check-in and data on whether reminder calls were successfully completed and whether the patient showed up to the appointment the next day.
Result/outcome:	After eight weeks of implementing the new procedure to update contact information, the no-show rate dropped from 22% to 12%.
Next Steps:	The new process for updating client contact information will be part of training for new hires employees. Clinic staff will continue to gather show-rate data on a daily basis and analyze the data quarterly to determine if the improvement theory continues to produce a low no-show rate.