Introduction The multidisciplinary assessment clinic (MDAC) is an outpatient service for older people at a district general hospital. Patients are triaged to the MDAC clinic if they have geriatric syndrome (for example falls) plus comorbidity and/or mobility, social or cognitive concerns. The service had a high ‘did not attend’ (DNA) rate compared with other geriatric outpatient clinics. This project aimed to reduce MDAC DNA rates and improve cost effectiveness through implementation of a new pre-appointment telephone service. Method We analysed six months of attendance data prior to establishing the pre-appointment telephone service. The existing system consisted of a standardised trust appointment letter and a text message reminder. For the new system a healthcare assistant (HCA) telephoned patients the day before their appointment to confirm attendance and discuss any concerns. We analysed six months of attendance data following the implementation of the new system and compared DNA rates. Results Prior to implementation of the new pre-appointment telephone service, 29 of 268 patients DNA (11%). From the second data set, following implementation of the new telephone system, 11 of 253 patients DNA (4%). Successful contact was made with 72% of those phoned, allowing confirmation or cancelled appointments to be rebooked. Chi square analysis found a significant difference between the two systems, with a p value of <0.01 indicating an improvement in attendance rates with the new system. Conclusion Telephoning frail older patients prior to an outpatient clinic appointment significantly reduces DNA rates—a similar system could be implemented in other geriatric medicine outpatient settings.

中文翻译：

---

2222 给体弱的老年人打个电话可以提高门诊就诊率


简介 多学科评估诊所 （MDAC） 是地区综合医院为老年人提供的门诊服务。如果患者患有老年综合征（例如跌倒）加上合并症和/或行动不便、社交或认知问题，则将被分流到 MDAC 诊所。与其他老年门诊诊所相比，该服务的“未参加”（DNA） 率很高。该项目旨在通过实施新的预约前电话服务来降低 MDAC DNA 率并提高成本效益。方法 在建立预约前电话服务之前，我们分析了六个月的出勤数据。现有系统由标准化的信托预约信和短信提醒组成。对于新系统，医疗保健助理 （HCA） 在预约前一天给患者打电话，以确认就诊情况并讨论任何问题。我们分析了实施新系统后六个月的出勤数据，并比较了 DNA 率。结果 在实施新的预约前电话服务之前，268 名患者中有 29 名 （11%） 进行了 DNA。从第二个数据集来看，在实施新电话系统后，253 名患者中有 11 名 （4%） 的 DNA。与 72% 的电话成功联系，允许重新预订确认或取消的约会。卡方分析发现两个系统之间存在显著差异，p 值为 <0.01 表明新系统的出勤率有所提高。结论 在门诊预约前给虚弱的老年患者打电话可显著降低 DNA 率——类似的系统可以在其他老年医学门诊环境中实施。