178 - Missed Pediatric Dental Visit Rates in Missouri: A Quality Improvement Project​

Purpose: This study’s purpose is to review interventions for improving the missed appointment rate (MAR) for pediatric dental appointments at a Federally Qualified Health Center (FQHC) (dental clinic at Compass Health Children’s Center- Columbia, MO). 

Methods: This study is designed based on the Institute of healthcare Improvement “Model for Improvement”, which involves testing changes using Plan-Do-Study-Act (PDSA) cycles. The subjects included pediatric patients ages 0-17 years old with basic operative and recare appointments. The project team identified potential causes for missed appointments and selected the intervention of implementing Phreesia (Phreesia Inc. Wilmington, DE) to adjust appointment reminders to five days in advance with follow-up reminders if no confirmation was received. Pre-intervention and post-intervention data were collected and analyzed with control charts. 

Results: The respective pre- and post-intervention missed appointments rates were 34% and 37% for recare patients and 33% and 40% for basic operative patients. The results showed that the selected intervention had a negative impact on missed appointment rates. 

Conclusions: Based upon the finding, an automated five-day in advance reminder system did not improve the missed appointment rates for recare and operative pediatric patients, which indicated that another cycle of the Plan-Do-Study-Act process should be implemented. 


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