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SACAD: Scholarly Activities

Abstract

Missed medical appointments contribute to revenue loss, workflow inefficiencies, increased staff burden, and reduced patient access to care in primary care settings. This Doctor of Nursing Practice (DNP) quality improvement project evaluated the impact of an automated text message (SMS) reminder system on no-show rates in a privately owned, medium-sized family practice in a rural setting, aiming to reduce the baseline no-show rate of 11.4% to 10% or less. Guided by the Model for Improvement and the Plan-Do-Study-Act (PDSA) framework, automated SMS reminders were sent 48 hours prior to scheduled appointments. Existing 24-hour phone call reminders were maintained. Formative assessments were conducted during the initial implementation, followed by monthly summative evaluations. Appointment adherence data were extracted from the practice’s scheduling software and analyzed using run charts and descriptive statistics. A z-test for the difference between two proportions was conducted to evaluate the statistical significance of the observed change, which was found to be statistically significant (z = -6.82, p < 0.001), indicating that the observed improvement was unlikely to be due to chance alone. Following implementation, the no-show rate decreased from 11.4% to 7.4%, exceeding the project aim and demonstrating a statistically and clinically meaningful improvement. . This project demonstrates that integrating automated SMS reminders into existing reminder workflows is an effective, sustainable, and cost-effective strategy for reducing no-show appointments in primary care and improving access to patient-centered care.

Faculty Advisor

Dr. Jenny Manry

Department/Program

Nursing

Submission Type

online only poster

Date

4-8-2026

Rights

Copyright the Author(s)

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