‘Getting to clinic study’: A mixed methods study of families who fail to attend hospital outpatient clinics

Aim Non‐attendance rates at paediatric hospital outpatient clinics are high; however, parent‐reported reasons for non‐attendance are poorly understood. We aimed to identify: (i) modifiable system and parent factors that prevent parents from attending paediatric outpatient clinic appointments with their child; and (ii) parent views on changes that could be made to reduce non‐attendance. Methods Interviews were conducted with a random sample of parents of children aged 0–18 years who did not attend scheduled new or review outpatient clinic appointments at a metro, tertiary children's hospital in Melbourne, between 1 May and 31 July 2017. Families were excluded if the principal investigator had previously cared for the child in clinic. Results A total of 50 parents completed an interview. Common factors related to non‐attendance were reported as not receiving an appointment letter ( n = 13, 26%) or text reminder ( n = 16, 32%); and difficulties making changes to scheduled appointments ( n = 11, 22%). Parents suggested a number of ways hospitals could reduce non‐attendance, including flexible clinic times, reduced waiting periods, cheaper parking, consistent text reminders of upcoming appointment and, overwhelmingly, the ability to reschedule via text, removing the need to telephone the hospital. Conclusions The principal reasons families struggle to attend appointments is being unaware of appointments, not receiving letters or text reminders. The lack of correct contact details held by the hospital's electronic medical record suggest systems errors in communication are impacting attendance rates of children in the clinics, and that addressing these internal issues may increase clinic attendance rates.