Understanding the impact and causes of 'failure to attend' on continuity of care for patients with chronic conditions

Aim: To understand the impact and causes of 'Failure to Attend' (FTA) labelling, of patients with chronic conditions. Background: Nurse navigators are registered nurses employed by public hospitals in Queensland, Australia, to coordinate the care of patients with multiple chronic condi...

Full description

Bibliographic Details
Main Authors: Byrne, A.L., Baldwin, A., Harvey, C., Brown, Janie, Willis, E., Hegney, D., Ferguson, B., Judd, J., Kynaston, D., Forrest, R., Heritage, B., Heard, D., McLellan, S., Thompson, S., Palmer, J.
Format: Journal Article
Language:English
Published: PUBLIC LIBRARY SCIENCE 2021
Subjects:
Online Access:http://hdl.handle.net/20.500.11937/87127
_version_ 1848764897372930048
author Byrne, A.L.
Baldwin, A.
Harvey, C.
Brown, Janie
Willis, E.
Hegney, D.
Ferguson, B.
Judd, J.
Kynaston, D.
Forrest, R.
Heritage, B.
Heard, D.
McLellan, S.
Thompson, S.
Palmer, J.
author_facet Byrne, A.L.
Baldwin, A.
Harvey, C.
Brown, Janie
Willis, E.
Hegney, D.
Ferguson, B.
Judd, J.
Kynaston, D.
Forrest, R.
Heritage, B.
Heard, D.
McLellan, S.
Thompson, S.
Palmer, J.
author_sort Byrne, A.L.
building Curtin Institutional Repository
collection Online Access
description Aim: To understand the impact and causes of 'Failure to Attend' (FTA) labelling, of patients with chronic conditions. Background: Nurse navigators are registered nurses employed by public hospitals in Queensland, Australia, to coordinate the care of patients with multiple chronic conditions, who frequently miss hospital appointments. The role of the nurse navigator is to improve care management of these patients. Evidence for this is measured through improvement in patient self-management of their conditions, a reduction in preventable hospital admissions and compliance with attendance at outpatient clinics. Failure to attend (FTA) is one measure of hospital utilisation, identifying outpatient appointments that are cancelled or not attended. Method: The cohort for this study was patients with multiple chronic conditions, and nurse navigators coordinating their care. Data describing the concept of FTA were thematically analysed twelve months into this three year evaluation. Results: Although the patient is blamed for failing to attend appointments, the reasons appear to be a mixture of systems error/miscommunication between the patient and the health services or social reasons impacting on patient's capacity to attend. Themes emerging from the data were: access barriers; failure to recognise personal stigma of FTA; and bridging the gap. Conclusion: The nurse navigators demonstrate their pivotal role in engaging with outpatient services to reduce FTAs whilst helping patients to become confident in dealing with multiple appointments. There are many reasons why a patient is unable to attend a scheduled appointment. The phrase 'Failure to Attend' has distinctly negative connotations and can lead to a sense of blame and shame for those with complex chronic needs. We propose the use of the neutral phrase “appointment did not proceed” to replace FTA. Implications for Nursing management: This article advocates for further consideration of collaborative models that engage the patient in their care journey and for consideration of the language used within the outpatient acute hospital setting, proposing the term 'appointment did not proceed.
first_indexed 2025-11-14T11:26:39Z
format Journal Article
id curtin-20.500.11937-87127
institution Curtin University Malaysia
institution_category Local University
language English
last_indexed 2025-11-14T11:26:39Z
publishDate 2021
publisher PUBLIC LIBRARY SCIENCE
recordtype eprints
repository_type Digital Repository
spelling curtin-20.500.11937-871272022-01-13T02:18:05Z Understanding the impact and causes of 'failure to attend' on continuity of care for patients with chronic conditions Byrne, A.L. Baldwin, A. Harvey, C. Brown, Janie Willis, E. Hegney, D. Ferguson, B. Judd, J. Kynaston, D. Forrest, R. Heritage, B. Heard, D. McLellan, S. Thompson, S. Palmer, J. Science & Technology Multidisciplinary Sciences Science & Technology - Other Topics Aim: To understand the impact and causes of 'Failure to Attend' (FTA) labelling, of patients with chronic conditions. Background: Nurse navigators are registered nurses employed by public hospitals in Queensland, Australia, to coordinate the care of patients with multiple chronic conditions, who frequently miss hospital appointments. The role of the nurse navigator is to improve care management of these patients. Evidence for this is measured through improvement in patient self-management of their conditions, a reduction in preventable hospital admissions and compliance with attendance at outpatient clinics. Failure to attend (FTA) is one measure of hospital utilisation, identifying outpatient appointments that are cancelled or not attended. Method: The cohort for this study was patients with multiple chronic conditions, and nurse navigators coordinating their care. Data describing the concept of FTA were thematically analysed twelve months into this three year evaluation. Results: Although the patient is blamed for failing to attend appointments, the reasons appear to be a mixture of systems error/miscommunication between the patient and the health services or social reasons impacting on patient's capacity to attend. Themes emerging from the data were: access barriers; failure to recognise personal stigma of FTA; and bridging the gap. Conclusion: The nurse navigators demonstrate their pivotal role in engaging with outpatient services to reduce FTAs whilst helping patients to become confident in dealing with multiple appointments. There are many reasons why a patient is unable to attend a scheduled appointment. The phrase 'Failure to Attend' has distinctly negative connotations and can lead to a sense of blame and shame for those with complex chronic needs. We propose the use of the neutral phrase “appointment did not proceed” to replace FTA. Implications for Nursing management: This article advocates for further consideration of collaborative models that engage the patient in their care journey and for consideration of the language used within the outpatient acute hospital setting, proposing the term 'appointment did not proceed. 2021 Journal Article http://hdl.handle.net/20.500.11937/87127 10.1371/journal.pone.0247914 English http://creativecommons.org/licenses/by/4.0/ PUBLIC LIBRARY SCIENCE fulltext
spellingShingle Science & Technology
Multidisciplinary Sciences
Science & Technology - Other Topics
Byrne, A.L.
Baldwin, A.
Harvey, C.
Brown, Janie
Willis, E.
Hegney, D.
Ferguson, B.
Judd, J.
Kynaston, D.
Forrest, R.
Heritage, B.
Heard, D.
McLellan, S.
Thompson, S.
Palmer, J.
Understanding the impact and causes of 'failure to attend' on continuity of care for patients with chronic conditions
title Understanding the impact and causes of 'failure to attend' on continuity of care for patients with chronic conditions
title_full Understanding the impact and causes of 'failure to attend' on continuity of care for patients with chronic conditions
title_fullStr Understanding the impact and causes of 'failure to attend' on continuity of care for patients with chronic conditions
title_full_unstemmed Understanding the impact and causes of 'failure to attend' on continuity of care for patients with chronic conditions
title_short Understanding the impact and causes of 'failure to attend' on continuity of care for patients with chronic conditions
title_sort understanding the impact and causes of 'failure to attend' on continuity of care for patients with chronic conditions
topic Science & Technology
Multidisciplinary Sciences
Science & Technology - Other Topics
url http://hdl.handle.net/20.500.11937/87127