Reducing Missed Appointments: RCC Project Strengthens Family Engagement in Mental Health Services

A staff-driven quality improvement initiative is helping more children, youth, and families stay connected to care.

(Photo courtesy: Markus Spiske, Unsplash)

At the Hôtel-Dieu Grace Healthcare Regional Children’s Centre (RCC), a recent quality improvement project is making a measurable difference in how families engage with counselling and therapy services.

Like many organizations, RCC experienced an increase in missed appointments and same-day cancellations following COVID-19. These disruptions can have a real impact, limiting the effectiveness of treatment and making it more difficult for children and youth to receive consistent care.

In response, RCC brought together frontline staff, families, and its Department of Research and Evaluation to better understand what was getting in the way of participation and what could help.

Using a community-based participatory approach, the project engaged 25 frontline staff, the Family Engagement Committee, and parents with lived experience. Together, they explored the barriers families face when trying to attend appointments and stay engaged in treatment.

The findings were clear. Families identified a range of challenges, including scheduling conflicts, childcare needs, extracurricular activities, and the stress associated with treatment itself. Staff data also showed that 31 families accounted for 248 no-shows and same-day cancellations over a two-year period.

From there, staff worked collaboratively to design practical, family-focused solutions. Three key strategies were implemented:

• Automated appointment reminders
  
• An updated service process for cancellations and no-shows
  
• A psychoeducation infographic to help families better understand and prepare for treatment

The results were significant.

Within four months of implementation, the number of families with frequent missed appointments dropped by 46 per cent. Overall, no-shows and same-day cancellations decreased by 44 per cent, with same-day cancellations alone reduced by 55 per cent.

Just as importantly, staff reported that the new approaches were both useful and sustainable. All three strategies remain in place today, with some now being expanded to other outpatient programs across RCC due to their success.

“Improving access to care starts with understanding what families are facing and responding in ways that truly help. This project shows how thoughtful, collaborative changes can keep children, youth, and families connected to care. We are grateful to the WE-SPARK Health Institute for its Igniting Discovery Grant, which enabled this work to begin.” — DJ MacNeil, Director, Mental Health and Addictions Hôtel-Dieu Grace Healthcare.

The project has also been shared more broadly, with presentations at regional and provincial conferences, and a manuscript currently in development for publication.

By Cathy Mombourquette