Various issues reveal during the nursing practice, and new professionals can study them to achieve quality improvement. In the East Orange Hospital Clinic, most beneficiaries represent the impoverished population, and the problem of skipping the follow-up appointments has recently occurred. Indeed, more than 25% of patients did not attend the planned visit with their doctor during the last month. The issue is urgent because missing the follow-up harms the quality of services and increases the risk of clients’ conditions worsening. It is in the practitioner’s power to influence the situation and change patients’ behavior through practical interventions and policy updates (Williamson et al., 2021). This paper aims to discuss the problem of the increased number of skipped follow-up visits among the impoverished population and develop a related PICOT question.
Skipped follow-ups are a serious issue, and there are several reasons why patients choose not to see their doctor after their first appointment. Beneficiaries’ socioeconomic situation is one of these elements since it affects their priorities and the cost of healthcare insurance services (Dantas et al., 2018). Indeed, employment and family obligations, costly transportation, and long clinic wait times prevent impoverished populations’ representatives from re-attending a hospital (Ofei-Dodoo et al., 2019). The problem is directly related to the practice because the services’ delivery impacts clients’ decision-making. For instance, patient education can include the practitioners’ describing the low engagement with healthcare recommendations as harmful behavior, encouraging the patients to avoid it and complete their treatment with all appointments (Williamson et al., 2021). Skipped follow-ups are severe for the organizations because they reduce efficiency, increase costs, and waste the previous treatment outcomes (Dantas et al., 2018). Consequently, the issue is essential to nursing practitioners because it determines the quality of their work and can dramatically damage the health outcomes of impoverished patients.
The problem of skipped follow-ups can be addressed to diverse clients; however, the practicum site’s beneficiaries mostly represent the low-income groups. Studying the literature and researching the impoverished population would be appropriate for developing the solutions. Such groups tend to prioritize saving finances and affording only the minimum of healthcare services even when their conditions require more complicated interventions (Ofei-Dodoo et al., 2019). Furthermore, the impoverished populations frequently have language barriers, lack sufficient education, and lead an unhealthy lifestyle.
Intervention for skipping follow-up visits must be based on the research about the population and include multiple influence channels simultaneously. In fact, administrators can create reminder procedures, and doctors can enhance patient education by emphasizing the need of keeping appointments. In order to make sure the client knows the significance of follow-up visits, nurses can also modify their communication style. In comparison, another solution can be no actions taken on the practicum site’s workers, yet patients’ worsening conditions due to the skipped appointment can be explained as their responsibility. In such a case, the number of missing follow-up visits would also decrease as the clients will learn through the experience and share it with their friends and family.
Through attendance tracking, the result is a decrease in the number of follow-up visits that the poor populations skip. The hospital uses an electronic record system, which is where the data for analysis would be obtained. The number of follow-up visits that doctors assign to their underprivileged patients will determine how long it takes to implement the plan and produce noticeable outcomes. The average period, such as three months, can be chosen for checking if the percentage of missed appointments changed.
The PICOT question is: “In impoverished patients, what is the efficiency of treatment if they are encouraged to attend the follow-up visit, compared to no intervention within three months?”
References
Dantas, L. F., Fleck, J. L., Oliveira, F. L. C., & Hamacher, S. (2018). No-shows in appointment scheduling–a systematic literature review. Health Policy, 122(4), 412-421. Web.
Fandino, W. (2019). Formulating a good research question: Pearls and pitfalls. Indian Journal Of Anaesthesia, 63(8), 611. Web.
Ofei-Dodoo, S., Kellerman, R., Hartpence, C., Mills, K., & Manlove, E. (2019). Why patients miss scheduled outpatient appointments at urban academic residency clinics: A qualitative evaluation. Kansas Journal of Medicine, 12(3), 57. Web.
Williamson, A. E., McQueenie, R., Ellis, D. A., McConnachie, A., & Wilson, P. (2021). ‘Missingness’ in health care: Associations between hospital utilization and missed appointments in general practice. A retrospective cohort study. PloS One, 16(6), e0253163. Web.