GLOUCESTERSHIRE HOSPITALS NHS FOUNDATION TRUST TEXTING REMINDER SERVICE UPDATE ON PILOT IN PAEDIATRIC OUTPATIENTS DECEMBER 2007 1. BACKGROUND 1.1 A pilt was apprved t send text reminders f the date and time f appintment in Paediatric Outpatient departments. 1.2 Parents were asked fr cnsent t text an appintment reminder fr their next fllw-up utpatient appintment. Text reminders were sent ut ne week befre the appintment. A standard appintment template message was used Please remember yur child s appintment at Battledwn Outpatients n date and time. If yu are unable t attend r require further infrmatin, please call 08454 224124. 1.3 Texts were sent as grup messages, ie. ne message culd be sent t many cntacts in ne actin. 1.4 On current text usage, ne text message csts 9p t remind f an appintment. A fllw up appintment in Paediatric medicine has an assciated PbR incme f 122, new appintment 239. 2. OUTCOMES 2.1 Appendix 1 includes an infrmatin analysis f texts sent and fllw-up DNA rates in paediatric medicine at CGH. 2.2 Results indicate a reductin in fllw-up DNA rates assciated with an increase in texting reminders. Of nte was the week beginning 1 st Octber 2007 where, due t an errr in the uplad, text messages were nt sent. In this week, the fllw-up DNA rate increased t 27%. 2.3 Fllw-up DNA rates in Octber drpped t a recrd lw f 3% in ne week. 2.4 A mnthly summary at CGH in paediatric medicine shws a steady decrease in DNA rate: MONTH FOLLOW-UP DNA RATE July 2007 18% August 2007 17% September 2007 14% Octber 2007 15% Nvember 2007 11% 2.5 Cst YTD = 600 annual license fee (t run until May 2008), plus 29.25 in text message charges n small scale pilt. In Nvember 2007 alne, reducing the fllw up DNA rate frm 18% t 11% - has released an additinal capacity f 26 fllw ups in the mnth at a related incme f 3,172. 2.6 A feedback survey was crdinated by the PPI department included as Appendix 2. The majrity f respndents felt that the text reminder service was an excellent idea.
3. NEXT STEPS AND ISSUES 3.1 The pilt prceeded n an pt in basis and mbile numbers were recrded n paper. This had a number f assciated prblems such as filing f paper recrds, recrding f accurate appintment dates and times, prblems with amendments if appintments were cancelled r change. This als meant that parents had t be asked t repeat this prcedure fr every attendance. 3.2 In rder t rll ut n a larger scale, this needs t prceed t an pt ut basis and the methd t capture the mbile phne number and the decisin t pt ut needs t be electrnic. 3.3 In cnsultatin with Sue Dennis and Steve Edwards, the fllwing has been agreed t prceed t an pt ut psitin : T infrm and advise patients f the use f their mbile phne number fr texting f reminders. T d this we will need t have psters and leaflets advising patients this is a methd that we will be using increasingly mre ften unless they bject. Fr new patients, we need a prcess t be able t infrm them with the initial appintment, e.g. including a leaflet with the appintment letter. It must be clear as t wh they cntact if they d nt wish t be texted with an appintment. The suggestin is fr this t be Sue Dennis as Caldictt Guardian. We need t have a prcess t enable the mbile phne details and the decisin t pt ut t be recrded electrnically. Fr this pilt t rll ut n a larger scale, an electrnic slutin needs t be agreed. 4. CONCLUSION 4.1 The pilt has reduced the fllw-up DNA rate in Paediatrics. 4.2 The patient feedback survey was very psitive. 4.3 Other areas in the Trust have already expressed interest in rll ut t their departments, e.g. Alisn Andersn leading fr Diabetes/Endcrinlgy and Bernie Turner fr Theatres. 5. RECOMMENDATIONS 5.1 The texting cmpany has expressed interest in spnsring the prductin f psters and leaflets. This wuld be agreed in liaisn with the PPI Department and is dependant n a suitably agreed IT slutin. 5.2 Further wrk t be undertaken t agree ptins fr an IT slutin t recrd mbile phne numbers and electrnic cnsent t ensure clear data links t appintment dates and times. Optins currently being prgressed via IT and Infrmatin Unit. Paula Tambling General Manager Wmen and Children Divisin December 2007
Appendix 1 Glucestershire Hspitals NHS Fundatin Trust Fllw Up DNA rates at Cheltenham General Paediatric Outpatient Department Surce: tbl_p_2007 & tbl_p_2008 Cheltenham General Week cmmencing 04/06/2007 11/06/2007 18/06/2007 25/06/2007 02/07/2007 09/07/2007 16/07/2007 23/07/2007 30/07/2007 06/08/2007 13/08/2007 20/08/2007 27/08/2007 03/09/2007 10/09/2007 17/09/2007 24/09/2007 01/10/2007 08/10/2007 15/10/2007 22/10/2007 29/10/2007 05/11/2007 12/11/2007 19/11/2007 26/11/2007 Attended 63 75 84 65 77 50 57 31 54 64 70 57 20 39 78 72 82 76 70 76 61 39 76 78 93 86 DNA 13 17 10 11 14 14 16 3 12 13 18 9 4 9 9 12 14 28 15 11 2 3 5 18 7 12 DNA Rate % 17% 18% 11% 14% 15% 22% 22% 9% 18% 17% 20% 14% 17% 19% 10% 14% 15% 27% 18% 13% 3% 7% 6% 19% 7% 12% Number f patients texted during week 0 3 3 3 5 4 8 5 10 8 19 21 0 6 28 19 21 0 27 27 12 5 22 23 14 32 % texted 0% 3% 3% 4% 5% 6% 11% 15% 15% 10% 22% 32% 0% 13% 32% 23% 22% 0% 32% 31% 19% 12% 27% 24% 14% 33% DNA Attended Number f patients texted during week 120 100 80 60 40 20 0 04/06/2007 11/06/2007 18/06/2007 25/06/2007 02/07/2007 09/07/2007 16/07/2007 23/07/2007 30/07/2007 06/08/2007 13/08/2007 20/08/2007 27/08/2007 03/09/2007 10/09/2007 17/09/2007 24/09/2007 01/10/2007 08/10/2007 15/10/2007 22/10/2007 29/10/2007 05/11/2007 12/11/2007 19/11/2007 26/11/2007 35% 30% DNA Rate % % texted 25% 20% 15% 10% 5% 0% 04/06/2007 11/06/2007 18/06/2007 25/06/2007 02/07/2007 09/07/2007 16/07/2007 23/07/2007 30/07/2007 06/08/2007 13/08/2007 20/08/2007 27/08/2007 03/09/2007 10/09/2007 17/09/2007 24/09/2007 01/10/2007 08/10/2007 15/10/2007 22/10/2007 29/10/2007 05/11/2007 12/11/2007 19/11/2007 26/11/2007 Ntes: w/c 01/10/2007 texts sent = 0 due t technical errr with texting cmpany
Appendix 2 Text Reminder Prject Feedback Survey Nvember 2007 INTERIM REPORT Patient & Public Invlvement Department December 2007
Intrductin Text Reminder Prject Feedback Survey 2007 Battledwn Outpatients Department are currently pilting a text message reminder prject. The aim f this prject is t reduce the number f patients wh d nt attend their appintment by sending a text message 1 week befre a Childs appintment. This survey was carried ut t identify views f the Text Reminder Service accuracy f text message, timing f text message, whether the text reminded them f appintment. Respndents were als given the pprtunity t prvide qualitative cmments within the questinnaire regarding the service. 33 respndents wh received a text message were asked t cmplete the survey ver a three week perid during Nvember 2007. Respndents were given the ptin f returning the cmpleted questinnaire in a cllectin bx at receptin r taking a prepaid envelpe, fr return t the Patient & Public Invlvement Department. Summary f Results 97% f respndents stated that the text message was sent t a mbile 91% f respndents stated that the text messaged reminded them f the appintment 97% f respndents did nt need t rearrange the appintment 88% f respndents stated that the text message was sent at the right time 97% f respndents stated that the infrmatin in the text message was accurate The majrity f respndents felt that the text reminder service was an excellent idea that will help save mney fr the NHS. The majrity f respndents were white, female with a range f ages. This reprt has been prepared by Amy Silk Acting Patient & Public Invlvement Crdinatr
Appendix One Patient Cmments 33 cmments were made I think that the text message service is a really gd idea fr bth patients and the hspital. Patients wh are busy can frget appintments that have been made in advance. A weeks ntice is enugh time t rearrange any ther events that may have crpped up in the meantime. Hspital less missed appintments must save mney! Any cancelled appintments then have time t be backfilled. Excellent idea, mst ther services ffer this facility e.g. dentists Excellent idea t remind appt by text Excellent idea, wuld help a lt Had text fr this appintment. Great as an reminder but felt it was sent a bit t early Excellent idea wrked well Excellent Makes sure I remember, gd idea Gd care Excellent idea, thugh I always remember appintment it is gd idea fr thse wh frget! Help save mney fr NHS Gd idea excellent reminder Great idea as will make me remember! Gd idea. Helps t remind yu especially when appintments are made a lng time in advance I think it is an excellent idea. Fab reminder fr busy mums and saves many missed appintments fr the hspital Excellent reminding service. Help me as I have tendency t frget when busy perids Send message 2 r 3 days befre appintment Great Very gd service Apparently the appintment had been changed but TXT said riginal date and n letter had been sent re cancelled r changed appintment I had already remembered the appt but text msg a really gd idea Excellent service Excellent, very helpful Gd Have had text message reminders in the past, but did nt get a text fr tday s appintment Gd idea Gd idea Excellent service I think it is a brilliant and excellent idea I think this will be a gd idea. A gd reminder Gd idea I think it s a gd idea I think the text reminder service is a great idea. As I am a very busy persn and ccasinally have frgtten appintments Yes because I have t ring and ask abut appintments