Bridging the Gap in Patient Attendance: A DNP-Led Quality Improvement Project to Reduce No-Show Rate by Implementing Text Message Reminders

Author

• Charles D. Rogers, Fort Hays State UniversityFollow

Department

Nursing

Degree Name

Doctor of Nursing Practice (DNP)

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, with a z-test for proportions used to assess statistical significance. 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. Additional benefits included improved clinic workflow efficiency, reduced administrative burden, and enhanced patient engagement through two-way communication. 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.

Keywords

No-show rates, appointment adherence, text message reminders, SMS reminders, patient engagement.

Advisor

Dr. Jenny Manry

Date of Award

Spring 2026

Document Type

DNP Project

Recommended Citation

Rogers, Charles D., "Bridging the Gap in Patient Attendance: A DNP-Led Quality Improvement Project to Reduce No-Show Rate by Implementing Text Message Reminders" (2026). Master's Theses or Doctor of Nursing Practice. 3312.
Available at: https://scholars.fhsu.edu/theses/3312

Rights

© The Author