Date of Award

Spring 5-7-2021

Document Type

DNP Project

Project Team Faculty Member

Jodie Nehrt

Project Team Faculty Member

Albertina Perez

Project Team Faculty Member

April Schmidt


Barriers to keeping appointments, No show, Cancellations, Mental health



Accessing healthcare for mental illness is important but has been challenging to resolve. Due to barriers, individuals are missing appointments leading to long-term negative effects of poor patient outcomes, such as homelessness and suicide. Understanding why individuals cancel or do not show up to their appointments is crucial to resolve this nationwide problem. Further investigation is needed to identify what barriers cause individuals to miss appointments so interventions can be created to resolve it and improve patient care. For this study, those who did not attend their first or second appointments were called and given an eight-question survey. The information obtained revealed barriers that kept the individual from attending their appointments. Results of the data were used to formulate possible strategies or interventions that would alleviate the barriers affecting this patient population. There were 95 individuals who met criteria for the study, 49 participated. The top barriers identified were fear of contracting COVID-19 (n=12), treatment at a different facility due to wait times (n=9), lack of understanding why psychiatric evaluation was needed (n=6), and financial hardship (n=5). The other 17 participant barriers were: insurance problems, forgetting appointments, relocation, and transportation issues. Fear of contracting COVID-19 and financial hardship were the top barriers found and focused on in this project. The significance of this quality improvement project is to show that identifying barriers can lead to interventions that benefit this patient population. The success seen in this study revealed interventions that can be used by other offices experiencing similar appointment issues.

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