SCDAA 46th Annual National Convention

Abstract

Authors:
Mrs. carla Jones, Atrium Health: Levine Children's Hospital,Mr. Kenneth Mitten, Levine Children's Hospital Charlotte, NC    

Objective: Information from our pediatric sickle cell disease (SCD) clinic indicates that we have an average noncompliance rate for attendance of clinic appointments of 30%. Our objective was to determine barriers to clinic attendance and strategies to overcome these barriers to improve compliance for 1 month clinic appointments for pediatric patients (birth-21 years of age) with sickle cell disease (SCD) on hydroxyurea.
 
Method: Caregivers of Sickle Cell patients indicated via a survey 5 main barriers that prevented them from consistently attending their 1 month clinic follow ups. They were  transportation, inflexibility of employers, personal family issues, inconsistent contact information (frequent phone number and address changes) and even forgetfulness (no barriers) as primary reasons for missed clinic appointments. Pareto chart analysis revealed patients scheduled for 1 month appointments were most likely to miss appointments. A multidisciplinary team was formed and created an aim statement, current and ideal process flow maps, and tested multiple change ideas with small tests of change.  Changes tested include offering offsite lab visits, posting signage to assist with transportation, mailing letters after missed appointments, assisting with reminders in phones, reminder calls to patients with a history of missed appointments, and giving out patient expectation forms to new patients and at yearly appointments.