Doctor of Nursing Practice Program

• Committee Chair Name & Credentials:
  K. Melissa Smith Hayes, DNP, ANP-BC, CHFN
• Committee Member Name & Credentials:
  Susie Leming-Lee, DNP, MSN, RN, CPHQ

DNP Project Abstract

Increasing Referral Appointment Compliance Rates for Psychiatric Patients

Purpose
To increase the patient psychiatric referral appointment compliance rate from 31% to 100%, over a six-week period, in the psychiatric patient population at New Heart Medical.

Methods
This quality improvement project was aimed at revising the staff-assisted referral appointment scheduling process where the patient had their psychiatric referral appointment scheduled by staff before discharge from the clinic. This project took place in a primary care clinic owned and operated by a family nurse practitioner, situated in a low-income neighborhood where patients range from newborn to geriatric. This clinic saw an average of 25 patients daily with majority of patients (60%) between the ages of 19 and 45 years. The multidisciplinary team consisted of the clinic owner/provider, two medical assistants (who also function as schedulers), the patients, and the project lead (DNP Student). After meeting with the team to discuss the aim, action plan and data collection plan of the project, a new process flow map and algorithm was created by the project lead, the team was trained on the new standardized process, process flow posters were placed throughout the clinic, and implementation took place over six weeks, from May 30th, 2022, to July 8th, 2022. At the end of the six-week period data was collected and analyzed.

Results
After data analysis, it was found that the aim of the quality improvement project was met. 32 patients were referred for a psychiatric evaluation and all 32 patients (100%) were able to have their psychiatric referral appointment scheduled by clinic staff, prior to discharge from the clinic.

Implications for Practice

• The new process flow chart will continue to be the new standard of practice for all patients that are referred for psychiatric evaluation.
• Continuous data should be collected to determine the percentage of patients that attended their schedule appointment, to determine the effectiveness of staff scheduling on appointment attendance compliance.
• For the provider, she will have a clearer understanding of the psychological status of her psychiatric patients, allowing her to streamline their plan of care more precisely.
• For the patients, they will have improved outcomes, as they will be receiving the interdisciplinary, collaborative care that they need to address their needs holistically.