Abstract Missed appointment, referred to as “no-shows,” are appointments that were not attended or previously cancelled at least 24-hours prior to the scheduled time. Missed appointments negatively impact patients as well as health care systems. According to Ullah et al. (2018), the financial impact of missed appointments on the healthcare system is more than $150 billion a year. Also, patients with chronic health problems (who are noncompliant with their scheduled appointments) may cause their conditions to worsen. Researchers have implemented several strategies to reduce the negative effects of no-shows. The purpose of this literature review was to explore the effectiveness of appointment reminders. The question driving this literature review was whether the implementation of appointment reminders via other means were more effective in reducing no-show rates, compared to the standard appointment reminder via telephone call. An electronic search was conducted using CINAHL and PubMed. Inclusion criteria consisted of English language, peer-reviewed, academic journal articles published from 2017 to the present. A variety of articles were found, and five of those were critiqued for this review. The literature was synthesized using the John Hopkins Nursing Evidence-Based Practice Model. The key finding of this review is that telephone calls are the most efficient and feasible form of appointment reminders (Lance et al., 2021 & Lavin et al., 2017). Since phone bills are a normal expense for most businesses, health systems should be able to implement the use of this strategy. Keywords: appointment adherence, no-show, missed appointments, appointment attendance

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No-show appointments, also referred to as missed appointments, occur 23% to 34% annually in general practice care settings. Missed appointments can lead to reduction in appointment availability, decrease in provider/staff productivity, patient/provider discordance, disruption in continuity of care, and reduced quality of care. There is a gap in the nursing literature regarding effective interventions to reduce missed appointments. The purpose of this quality improvement, secondary analysis project was to determine whether implementation of an evidence-based no-show, nurse-led intervention would reduce missed appointment rates in a family medicine practice. The health belief model and the plan, do, study, act model guided this no-show project. Convenience sampled, password-secured quantitative data from nurse practitioner schedules were analyzed using a check-sheet tool and spreadsheet software. Data showed that after implementation of the evidence-based, nurse-led interventions, there was a reduction of no-shows with a decline from 23.5% in September and November 2017 to 17% in September and November 2018. Results of this no-show project might promote positive social change by increasing awareness of evidence-based interventions that are effective for reducing missed appointments in primary care practices.

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