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Faculty Chair: Dr. Somali Nguyen
Clinical Mentor: Dr. Connie White-Williams
Presented: DNP Orientation UAB School of Nursing, July 2023

Publication Date



DNP Orientation UAB School of Nursing


Birmingham, AL





Background: Heart failure is the leading cause of hospitalization and readmission among adults in the United States, costing over 30.7 billion annually. Inadequate self-management knowledge, barriers to providing patient-centered education, and follow-up failure are frequently cited themes precipitating readmission. The University of Alabama at Birmingham (UAB) Heart Failure Transitional Services for Adults (HRTSA) clinic is a medical home for uninsured or underinsured adult patients with heart failure who face two problems consistent with the literature. First, the HRTSA clinic has a monthly appointment no-show rate of 22.38 %. Second, one-on-one self-management education is not standard following the initial appointment. The purpose of this quality improvement project is to decrease no-show appointment rates at the UAB HRTSA clinic by implementing an evidence-based practice bundle.

Framework: The Donabedian conceptual model will serve as the framework for this project, guided by the three dimensions of care: structure, process, and outcomes.

Methods: Up to 50 patients with their second scheduled appointment between August 31, 2023, and October 31, 2023, will be selected for potential participation. Participants must be 19 or older, English-speaking, and may be of any gender, race, or ethnicity. Appointment cancellation, patient hospitalization, and cognitive or physical contraindications to receiving education or participating in a post-intervention survey preclude participation. Participants will receive a self-care management education session addressing signs and symptoms of decompensation, diet, exercise, and the importance of appointment adherence before the start of their second appointment. At this time, the meal voucher incentive will be described. A patient experience survey will be delivered via Qualtrics at the end of the appointment. If the patient returns for their follow-up, they will receive a 10-dollar meal voucher redeemable at the UAB hospital cafeteria.

Results: Descriptive statistics will be used to analyze changes in pre and post-intervention monthly appointment no-show rates and to evaluate patient experience survey responses. A retrospective chart review will be conducted to examine demographic information.

Implications of Intervention and Sustainability Plan: This adaptable, low-cost, minimalresource project can increase heart failure self-management knowledge and decrease monthly appointment no-show rates, generating improved health outcomes and fewer hospital readmissions.

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Creative Commons Attribution 4.0 International License
This work is licensed under a Creative Commons Attribution 4.0 International License.

The Impact of Self-Care Education and a Meal Voucher Incentive Program on No-Show Rates at the University Alabama at Birmingham Heart Failure Transitional Services for Adults Clinic

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