| Description |
This project is part of a long-term, grant funded project to design and create a low-cost, wearable appointment reminder device for homeless patients of an outpatient clinic. The intended role of this DNP Project was to test the first generation of such a device, but due to unforeseen circumstances, has become collection of data to aid in the design of the device. Problem Statement: Unplanned absences (no shows) at outpatient clinics result in decreased provider efficiency, loss of clinic revenue, and a lower number of patients served each day. Efforts are being made around the country to decrease the rate of no-shows in outpatient clinics using electronic reminder systems (primarily text messages and email messages), with promising results. Many homeless persons, however, do not have a working cell phone or ready access to a computer, and there is no way to send an appointment reminder to these patients. Objectives: 1) Assist a multidisciplinary team in the production of a low-cost, wearable reminder bracelet. 2) Complete a pilot/feasibility study of the device in patients at a homeless clinic in Salt Lake County. 3) Summarize results and disseminate through publication in a relevant journal. Literature Review: No-Show rates in outpatient clinics are as high as 55%, which can cost a clinic up to 15% of it's weekly income and result in poorer health outcomes for patients. Text and telephone messages improve appointment adherence rates in the general population, but only 50% of homeless patients have working cell phones. Implementation and Evaluation: Unexpected loss of key team members delayed production of the device. Implementation of an alternate intervention was undertaken, designed to assist in the successful adaption of the device. A brief survey was created and 42 patients were interviewed regarding their input on device design and function. The collected data was summarized and represented in graphs and charts, which were then shared with the device creation team. Initial models of the device housing have been produced and electronic components have been selected, based on the information collected through this project. Results: Although the bracelets could not be created and tested, a large amount of useful data was collected. Patients preferred rectangle or bar shaped devices, with rounded edges and flat profile. The most requested intervals for reminders were one hour prior to the appointment and the morning of the appointment. It is essential that the device be waterproof. Patients prefer neutral band colors like black and white, and prefer vibration as the mode of reminder. Summary: This DNP project has resulted in the collection, summarization, analysis, and sharing of patient preferences which will be fundamental to the successful development of a low-cost, wearable electronic appointment reminder device to be used by homeless patients. |
