Abstract
Background : Memory Assessment and Support Service (MASS) Team based in Sligo was set up on October 2023 under the National Dementia Model of care. Patients are referred to MASS service for assessment of cognitive symptoms, diagnosis, care planning and post-diagnostic support. Evidence has suggested that poor attendance of out-patient clinics has increased cost of care and waiting times and resulted wastage of resources 1,2,3. The MASS team comprises of three WTE and two part time WTE staff with consultant input with a gap in admin support for over 2-3months.
Who is it for? Patients referred to the MASS service and for all Multidisciplinary MASS team members that include 2 Registered Advanced Nurse Practitioners, 1 Clinical Nurse Specialist, 1 Senior Occupational Therapist, Part-time Dietitian, Part-time Consultant Psychiatrist.
Who did you involve and engage with? A retrospective analysis of all patients’ attendance was evaluated over a 9 month period (January – September 2023). This included appointment attendances for all Multidisciplinary MASS staff members.
What did you do? The aim was to identify the total number of patients that attended and did-not-attend scheduled MASS appointments and to improve efficiency in the process
Objectives:
(a)identify the total number of attendances and non-attendances by examination of patient database
(b)implement strategies to improve service delivery and standardise the appointment process
Results: Of the total 411 scheduled appointments in the form of outpatient appointments, virtual and domiciliary visits, the overall attendance rate was 89.3% and absenteeism rate was 10.7%. The appointments offered were in the form of a one off posted letter and/or phone calls with no further reminders offered for the visit. We also found not all appointments were registered on the team outlook calendar which was visible to all members of MASS. We identified that the least absenteeism was noted with the clinician who offered the most domiciliary visits. One patient’s family member highlighted the need for a reminder text or phone call prior to the appointment
Learning for the international audience: Standardising the process for booking appointments and setting up a reminder service may improve attendance and reduce absenteeism in Sligo MASS.
Next steps: We believe it is possible to enhance attendance and lower the absenteeism rate with little additional work and expense. However in the absence of administrative staff, appointment booking and follow up can reduce a clinician’s capacity for undertaking clinical work. This study highlights the importance of adequate administration staff and ICT systems for this role in a memory service. Once adequate systems and resourcing are in place we plan to review our attendance rates once again and we expect the non-attendance rate will improve.
References
1.Kelly BD. Internal audit of attendances at a psychiatry outpatient clinic. Irish journal of psychological medicine. 2008 Dec;25(4):136-40.
2.Do DH, Siegler JE. Diagnoses and other predictors of patient absenteeism in an outpatient neurology clinic. Neurology: Clinical Practice. 2018 Aug 1;8(4):318-26.
3.Sunkara TK, Richardson I. Literature review analyzing research on Do-Not-Attend (DNA) factors at health care clinics. 2021 University of Limerick