Reducing No-Show Rates in Virtual Pediatric Weight Management Visits: A Quality Improvement Initiative

Authors

Keywords:

Childhood Obesity, Pediatric obesity, Weight reduction programs, Telemedicine, Quality improvement, Patient appointment attendance, Reminder systems

Abstract

Background: Virtual delivery of comprehensive pediatric obesity treatment may reduce barriers such as time, cost, and travel distance. Despite these advantages, high no-show rates for first-time visits remain a significant challenge. The aim of this project was to reduce no-show rates for first-time visits by 10%.

Methods: This clinician-led quality improvement project included a needs assessment to identify barriers to attendance and four sequential Plan-Do-Study-Act (PDSA) cycles. Each cohort received one of the following interventions: (A) orientation phone call at referral, (B) orientation text message at referral, (C) reminder phone call, or (D) reminder text message. No-show rates before and after implementation were analyzed using control charts, linear regression, and chi-squared tests. Odds ratios (OR) and 95% confidence intervals (95%CI) were calculated to evaluate the association between interventions and attendance.

Results: A total of 845 eligible patients were included (pre-implementation n=480; post-implementation n=384). The baseline first-visit no-show rate was 38%. After implementation, the no-show rate decreased to 20%, representing an 18% absolute reduction (p=0.02). Pre-visit reminder interventions significantly improved attendance (Protocol C: OR=2.07, 95%CI=1.12-3.85, p=0.04; Protocol D: OR=2.66, 95%CI=1.12-6.33, p=0.02), whereas orientation interventions at referral showed no significant effect. Cost analysis demonstrated that reminder text messages required the least financial and labor investment ($606 annually; ~35 minutes/week), while reminder phone calls produced the greatest improvement relative to cost.

Conclusion: Pre-visit reminders delivered by phone or text significantly reduce first-visit no-show rates in pediatric weight management programs. These low-cost, scalable strategies may improve access and engagement in telehealth-based obesity care.

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Published

2026-03-16

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Mayer, M., Hegedus, E., & Vidmar, A. (2026). Reducing No-Show Rates in Virtual Pediatric Weight Management Visits: A Quality Improvement Initiative. International Journal of Medical Students. Retrieved from https://ijms.pitt.edu/IJMS/article/view/2756

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