QI 120 Improving Attendance in the CPIP (Cerebral Palsy Integrated Pathway) Clinic

Abstract

Aim: To reduce the mean DNA (Did Not Attend) / WNB (Was Not Brought) rate at the CPIP Clinic from 26.8% to 10% by July 2022.

The CPIP clinic experiences several missed appointments each week. These unused clinic slots are very costly due to multidisciplinary staff involvement. QI tools were used to monitor non-attendance, review processes and develop change ideas. PDSA cycles were used to test change ideas including the introduction of automated text messages and the streamlining of admin processes.

Tools Used: Driver Diagram - https://aqua.nhs.uk/wp-content/uploads/2023/07/qsir-driver-diagrams.pdf; PDSA Cycles - https://aqua.nhs.uk/wp-content/uploads/2023/07/qsir-pdsa-cycles-model-for-improvement.pdf; SPC Charts - www.england.nhs.uk/statistical-process-control-tool/; Process Mapping - https://aqua.nhs.uk/wp-content/uploads/2023/07/qsir-mapping-the-process.pdf.

Project Impact: The team reduced the DNA/WNB rate from 26.8% to 10.6% and implemented a cancellation process. They now have benchmarking data to assist them with the next steps of the project.

An unintended consequence of the project was an increase in the cancellation rate from 6.7% to 17.6%. This has led to a continuation of the project with a new project aim: To improve the mean attendance rate in the CPIP clinic from 71% to 90% by July 2023.