Graduation Semester and Year
Summer 2026
Document Type
DNP Project
Degree Name
Doctor of Nursing Practice
Department
Nursing
First Advisor
Kimberly Siniscalchi
Abstract
Background: Missed appointments undermine the benefits of telepsychiatry. An outpatient psychiatric practice in Texas reported a baseline no-show rate of 30.4%, exceeding national average and disrupting continuity of care, clinic efficiency, and revenue.
Purpose: Implement and evaluate a telepsychiatry adherence bundle—tiered automated reminders, structured pre-visit check-ins, and patient education—to reduce the no-show rate among adults receiving outpatient telepsychiatry care.
Methods: A pre- and post-quality improvement project, guided by the Plan-Do-Study-Act (PDSA) framework, delivered the bundle to all scheduled adult patients over eight weeks. De-identified appointment and demographic data were analyzed in SPSS using descriptive statistics and the Pearson chi-square test of independence.
Results: Of 182 scheduled appointments, the no-show rate fell from a 30.4% baseline to 20.9% post-intervention (χ² = 5.50, df = 1, p = .019), a 31.3% relative reduction, with 100% bundle fidelity. Insurance status significantly predicted missed appointments (χ² = 8.67, p = .003); uninsured patients missed 74.1% of visits, compared with 41.3% of insured patients.
Conclusion: The adherence bundle produced a significant, sustainable, low-cost reduction in telepsychiatry no-shows. Persistent disparities among uninsured patients indicate that future efforts should pair the bundle with targeted financial and digital-access support.
Keywords: Telepsychiatry, Patient adherence, Bundle intervention, No-show reduction, Quality improvement, Telehealth
Keywords
Telepsychiatry, Patient adherence, Bundle intervention, No-show reduction, Quality improvement, Telehealth
License
This work is licensed under a Creative Commons Attribution-NonCommercial-No Derivative Works 4.0 International License.
Recommended Citation
Erimwioghae, Steve, "Improving Patient Adherence to Telehealth Appointments by Implementing a Bundle Intervention" (2026). Doctor of Nursing Practice (DNP) Scholarly Projects. 15.
https://mavmatrix.uta.edu/nursing_dnpprojects2/15