Reason For Non-attendance Research Articles

The Relationship between Erciyes, Selçuk, and Akdeniz Medical School Third-Year Students’ Learning Approaches and Their Non-attendance Attitude and Tendencies

Background: Non-attendance is an undesirable student behavior. Although some studies about the factors for non-attendance behavior have been carried out at medical schools, the learning approach of a student has not been studied and it can also be a factor for non-attendance. We aimed to assess the relationship between learning approaches and non-attendance attitude and tendency. Methods: This is a correlational study. 644 students registered in three medical schools were enrolled. Data were collected during May 2015. “The Revised Two Factor Learning Approach Scale”, “Non-attendance Attitude Scale” and “Non-attendance Tendency Scale” were used as data collection tools. Results: Out of 478 studied students, 10.3% mentioned that they never missed theoretical classes and 71.3% mentioned that they never missed practical classes. Sleeplessness was the most common reason for non-attendance. 45.6% of all students thought that non-attendance affected student success. The students’ mean score for deep learning was 29.5±6.1 and for superficial learning was 30.5±5.6. The mean score for non-attendance attitude scale was 54.4±12.8 and from non-attendance tendency scale was 90.5±19.6. Conclusion: Learning approach is an effective factor for attendance. As deep learning approach is adopted, tendency for non-attendance decreases and the attitude becomes positive. Keywords: LEARNING, STUDENTS, MEDICAL, ATTENDANCE, ATTITUDE

Improving Nonattendance at Outpatient Pediatric Endoscopy Unit of a Tertiary Center.

Failure to attend pediatric outpatient endoscopic procedures leads to inefficient use of resources, longer wait-list times, and delay in diagnoses. The causes for pediatric endoscopy nonattendance are not well studied. The aim of the study was to identify factors associated with failure to attend endoscopic procedures and to assess the value of quality improvement (QI) interventions implemented to improve pediatric endoscopy attendance. This was a continuous QI project. We collected nonattendance data from November 2011 to November 2013. Information collected included procedure type, age, sex, time on the waiting list, history of previous procedures, and reason for nonattendance. The following QI interventions were implemented sequentially: an appointment reminder letter, a telephone call 1 week before procedure, and creation of an electronic medical note dedicated to endoscopy appointment. Pareto charts and statistical process control charts were used for analysis. From November 2011 to November 2013, we were able to decrease nonattendance from 17% to 11% (P = 0.005). No-show rate was reduced from 5% to 0.9% (P = 0.00001). There was no significant difference between attendees and nonattendees in relation to sex, age, or having a previous procedure. Longer waiting time (33 vs 26 days) was associated with increased risk for nonattendance (P = 0.0007). The most common causes for nonattendance were illness (31.5%), followed by caregiver/patients who no longer wanted the procedure (17.7%), and patients who improved (12.9%). Applying QI methods and tools improved pediatric endoscopy attendance. Longer wait time for endoscopic procedures is associated with nonattendance. Given the increased pediatric endoscopy demand, strategies should be implemented to reduce wait time for pediatric endoscopy.

Abstract 220: Understanding Nonattendance in Cardiac Transitional Care

Background: Bridging the Discharge Gap Effectively (BRIDGE) is a nurse practitioner based transitional care clinic shown to reduce readmissions in acute coronary syndrome patients. Unfortunately, more than 20% of patients referred do not attend. This study aims to determine reasons for nonattendance. Methods: Patients who did not attend their BRIDGE appointments between February and June 2014 were contacted by phone and surveyed about their reasons for nonattendance. Patient records were abstracted for discharge (D/C) and BRIDGE appointment details. Results: Of 171 patients referred, 60 (35.1%) did not attend their BRIDGE appointment; 45 (75.0%) participated in the study. Reasons for nonattendance were grouped into five categories (Table 1). The majority of patients reported their health status (n=15) as a reason for nonattendance or simply made a choice to not attend (n=16). Many patients (n=30, 66.7%) did not recall receiving information about BRIDGE at D/C. However, of those who did (n=10) nearly all (90.0%) understood the rationale for the appointment (Table 2). A high percentage of these patients were readmitted within 30 days (n=11, 24.4%) and patients who reported being too ill to travel were readmitted more frequently (4 of 7, 57.1%). These rates are in stark contrast to the 8.3% 30-day readmission rate for attenders. Conclusions: Patients had a variety of reasons for nonattendance, illustrating multiple opportunities to impact attendance rates. Focus should be placed on identifying and addressing patients who are too ill to travel as they represent a population at high risk for complications post-discharge. Further research, in a larger sample, is warranted to better understand these patients and their transitional needs.

361 – Audit of attendance of clozapine clinic two years after first audit

Aim of audit was to assess attendance at clinic and determine factors that might influence attendance. The outcome of the audit showed that mainly young men from South asian background were not attending. Recommendations from the audit included education of patient about illness and importance of maintenance treatment, education of family about illness so they can get more involved in treatment and encourage patient's compliance with treatment. Observe trends in attendance according to ethnicity. Re-evaluate attendance after recommendations were put into practice. Look at clinic lists and note DNA (did not attend) in clozapine clinic over period of 3 months. Note ethnicity of patients. 39 patients were booked into clozapine clinic over period of 3 months 8 DNA's - 2 black british and 6 white english Reasons for non attendance: 1 black british works full time, 1 black british AOT client, 1 white english was physically unwell, 1 discontinued clozapine without informing services. Another important reason for non attendance: patients don’t tend to attend clozapine clinic if blood test is not due the same day. Improvement of non attendance in South Asian client group due to education of patient and family about illness and treatment. Non attendance in other client group is mainly due to non concordance between blood test appointment and clinic appointment. Treatment team should consult client's diary to synchronise the time of blood test with time of clinic appointment.

Why Do People Choose Not to Have Screening for Hemochromatosis?

Hemochromatosis is a common disorder of iron overload most commonly due to homozogosity for the HFE C282Y substitution. A workplace-screening program was conducted in which over 11,000 individuals were screened for this mutation. A substudy of this project was to ascertain why people chose not to attend information and screening sessions offered in their workplace. Staff were recruited by email, questionnaires in common areas, and direct approach. A purpose-designed questionnaire sought the reasons for not attending information and screening sessions. The nonattender questionnaire was distributed at 24 workplaces and completed by 872 individuals. The most common reason for not attending sessions, accounting for 70.1%, was practical (e.g., unaware of session, too busy, or unavailable). Other relatively common reasons were that the individual had low iron levels or were a blood donor (14.9%), or that hemochromatosis was considered unimportant (12.2%). Insurance concerns were very rarely cited as the reason for nonattendance (1.0%). The nonattender data presented here indicate that concerns about insurance, anxiety, and use of genetic information are not major factors for why people did not attend workplace information and screening sessions for hereditary hemochromatosis. Practical barriers were the major reasons identified. This highlights that when implementing screening programs, as many practical barriers as possible need to be overcome, so that a maximum number of people who would like to be informed about screening are given the opportunity to do so.

Nonattendance at outpatient endoscopy.

Nonattendance at outpatient endoscopy leads to inefficiency and delay in diagnosis. We aimed to identify factors associated with failure to attend outpatient gastroscopy and colonoscopy. We carried out a retrospective audit of nonattendance at outpatient endoscopy over a 12-month period at our tertiary hospital endoscopy unit. Attending patients on the same endoscopy list were used as controls. Patient charts and referral letters were reviewed. The information collected included referral source, time between referral and procedure, indication and type of procedure, reason for nonattendance and history of previous endoscopy. Following the audit a trial of telephone reminders was implemented over a 3-month period. From 2157 outpatient procedures that were scheduled, 263 nonattendees (12.2 %) were identified with 261 controls. Of the nonattendees, 109 (41 %) did not attend for colonoscopy, 121 (46 %) did not attend for gastroscopy and 33 (13 %) failed to turn up for combined procedures. Monday was the most common day of the week for nonattendance (40 % of nonattenders). Nonattendees were younger (46 +/- 14 vs. 55 +/- 16, P < 0.001), less likely to be referred from a gastroenterologist ( P < 0.001) or private practice ( P = 0.02) and more likely to be referred from the emergency department ( P = 0.007). Subsequent to this, a 3-month period of telephone reminder reduced nonattendance rates from 12.2 % to 9 % ( P = 0.03). Younger patients scheduled for outpatient endoscopy on Mondays who are not referred by a gastroenterologist or private physician are more likely not to attend. These patients should be targeted for interventions designed to increase attendance. Telephone reminders have a modest effect on reducing nonattendance rates.