Reducing no-show rates in an outpatient oncology infusion center: A multi-faceted intervention approach.

429 Background: Missed appointments in hematology oncology infusion centers disrupt continuity of care, negatively impact patient outcomes, and increase healthcare costs. As part of the American Society of Clinical Oncology’s Quality Training Program, we aimed to understand how social determinants of health impacted our patient population. The initiative targeted a site located in our most underserved community, and more specifically, our benign hematology population, which exhibited the highest incidence of no-show appointments. Methods: Through patient surveys and staff feedback, we identified contributing factors affecting the patient no-show rate that extended beyond social determinants of health (SDOH). These included internal operational elements such as our call confirmation process, scheduling workflow, and check-out procedures. Over a three-month period, we implemented a multifaceted intervention to improve appointment adherence. Key components included: a scheduling cap that limited patients to no more than three upcoming treatment appointments to minimize scheduling fatigue, personalized reminder phone calls one day prior to scheduled appointments, and enhanced flexibility in scheduling. Appointment data was collected through Epic and iQueue via LeanTaas, with manual validation conducted to ensure data accuracy. Statistical process control charts were used to analyze the impact of our interventions on our outcomes. Results: Post-intervention analysis demonstrated a substantial reduction in no-show rates, declining from 33% to 13%. This improvement highlights the impact of modifying operational practices to align with patients’ social and logistical realities. The initiative not only improved appointment adherence but also contributed to more efficient clinic operations and better resource allocation. Conclusions: Integrating awareness of SDOH into scheduling workflows can significantly enhance patient adherence and care continuity. These results demonstrate that patient centered scheduling and communication strategies can significantly improve appointment adherence in high-acuity outpatient settings. Continued efforts will focus on sustaining this progress and evaluating potential expansion to other hematology oncology infusion sites. PDSA cycles and outcomes. PDSA Cycles PDSA 1(Nov 4, 2024) PDSA 2(Nov 4, 2024) PDSA 3(Nov 18, 2024) Intervention Day before reminder calls Only schedule 3 future appointments Nurses confirm patients' next appointment and provide after visit summary with appointment details No-Show Rate (%)Baseline 33% 17% (Dec 2024) 17% (Dec 2024) 13% (Jan-Mar 2025)