Abstract

In a faith-based rural healthcare clinic located in the south-central part of the United States (US), patient loss to follow-up appointments is the primary problem of the agency. Appointment nonadherence creates an inability to effectively manage patient disease processes which leads to poor patient outcomes. Missing scheduled appointments may also lead to medication nonadherence, increased morbidity, and exacerbation of complications related to the chronic diseases that are prevalent among the clinic's patients (Crutchfield & Kistler, 2020). The purpose of this project is implementation of strategies to decrease the average no show rate of patients at a rural faith-based healthcare clinic. This project was guided by the Iowa Model Revised: Evidence-Based Practice to Promote Excellence in Healthcare (Iowa Model) and the Health Promotion Model (HPM) by Nola Pender. Findings in literature demonstrate the usefulness of case management (CM) in a patient-centered medical home (PCMH) as a method of delivering person-centered care along with building a relationship of trust. These findings led to the adoption of the Care Manager [nurse case manager (NCM)] role and Health Information Portability and Accountability Act (HIPAA) compliant text message (TM) program. The change in practice is adopted by the agency and is sustained through integration within the agency's clinic workflow process with assessment of key indicators annually to assure ongoing quality. Ultimately, the implementation of practice change at this rural healthcare clinic will improve adherence to appointments and ensure that patients have routine access to quality health care. This will lead to improved patient outcomes by creating a PCMH and the secondary desired effect of more efficient utilization of volunteer time and increased satisfaction of the healthcare provider, nurses, and support staff.

Description

Acknowledgments: Fannin Health Clinic Board and Volunteers, Charlotte Kearney, Mary Manning, Angela Nelms, and Dianne Lehde as team members

Author Details

Kelli Jane Bowen, DNP, RN, CHSE

Sigma Membership

Non-member

Lead Author Affiliation

Samford University, Birmingham, Alabama, USA

Type

DNP Capstone Project

Format Type

Text-based Document

Study Design/Type

Quality Improvement

Research Approach

Translational Research/Evidence-based Practice

Keywords:

Low Income, Case Management, Rural Healthcare Clinic, Appointment No Show, Faith-Based, Text Message, Patient-Centered Medical Home

Advisor

Coleman, Jennifer

Degree

DNP

Degree Grantor

Samford University

Degree Year

2021

Creative Commons License

Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License.

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.

All permission requests should be directed accordingly and not to the Sigma Repository.

All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.

Review Type

None: Degree-based Submission

Acquisition

Self-submission

Date of Issue

2021-08-20

Full Text of Presentation

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