• Kara Hamilton, Sophie Short, Kathryn Cudby, Max Werner, Olivia O'Connor-Robertson, William Larkins, Devon Prangley, Ali Ibrahim, Brian Leung, Pauline Norris, and John D Dockerty.
• Dunedin School of Medicine, University of Otago, Dunedin, New Zealand.
• Intern Med J. 2023 Sep 1; 53 (9): 164816531648-1653.

BackgroundThere are significant implications for both patients and providers when patients do not attend outpatient specialist appointments. Nonattendance has an impact on the efficiency of health care, provider resources and patient health outcomes.AimsIn this qualitative study we aimed to gather insights on how Dunedin Hospital notifies patients about their appointments, the implications for the hospital and for patients and how the system could be improved.MethodsWe interviewed 13 hospital staff members and nine patients who volunteered to participate because they had missed appointments as a result of communication problems. Interviews were transcribed and analysed thematically using NVivo software.ResultsDunedin Hospital relies heavily on posted letters to inform people about their appointments, with some also receiving reminder texts closer to the time of the appointment. Frustration with the current system was a common theme among both patients and staff. Almost all patients had missed an appointment because of a letter not arriving. While most patients found that the text reminders were helpful, most said they were sent too late and did not allow enough time for arrangements to be made for their appointments. Almost all patients experienced treatment delays, which caused distress. Most patients believed a self-booking system would improve the ability to attend their appointments, and most of them wanted to be notified of appointments via email.ConclusionsWe recommend that a patient-oriented approach to communication should be implemented, and alternative methods of communication should be explored.© 2022 The Authors. Internal Medicine Journal published by John Wiley & Sons Australia, Ltd on behalf of Royal Australasian College of Physicians.

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