Test of an organizational change model to reduce no-shows in dental care settings.

OBJECTIVES To test the feasibility and preliminary effectiveness of the NIATx model for organizational change to reduce appointment no-shows in dental care settings. METHODS The NIATx Dental Pilot Study used a clustered prepost interventional design and a mixed-methods approach. Five independent dental clinics serving Medicaid enrollees were recruited. Quantitative data on the impact of the NIATx model were complemented by qualitative assessment information collected from dental staff. The NIATx model was applied through a multisite learning collaborative that engaged participating organizations in adopting targeted no-show best practices. The primary outcome measure was no-show data collected at the preintervention phase (5 months), intervention phase (7 months), and postintervention phase (3 months). RESULTS Female patients were in the majority (median 54.5 percent). Mean age ranged from 8 to 50 (median 35.2) years. The median percentage for Hispanics was 11.0 percent, and the proportion of uninsured patients was 25 percent. Preintervention no-show rates ranged from 14 percent (clinic B) to 38 percent (clinic E). All clinics had lower no-show rates during the postintervention period, with decreases ranging from 1 percent (clinic B) to 13 percent (clinic E). Overall, the no-show rates decreased in the study. CONCLUSIONS The study demonstrated the feasibility of applying the NIATx model to reduce no-show rates, with some difficulty observed with sustainability across dental practices during the postintervention period.