Assessing Practice Initiatives and Leadership Approaches - DN753

This report synthesizes literature on practice initiatives and leadership approaches in healthcare, emphasizing their impact on financial returns and patient care delivery. The report addresses the issue of patient no-shows, which negatively affects resource utilization and patient outcomes. It explores various leadership approaches such as situational, contingency, and relationship techniques to minimize no-shows. The report analyzes the impact of missed appointments on medical costs, care quality, and waiting times. It also examines how patient no-shows affect racial and ethnic minorities, and the role of technology and management approaches in mitigating these issues. The report highlights the importance of change theory, and how it can be used to assess the impact of investments in medical facilities. The findings underscore the need for healthcare facilities to adopt proactive strategies to improve patient attendance and optimize resource allocation, ensuring better patient outcomes and financial stability. The report is supported by several peer-reviewed sources and follows APA 6th edition style.

Running head: ASSESSING PRACTICE INITIATIVES AND LEADERSHIP APPROACHES 1
Assessing Practice Initiative and Leadership Approaches
Student’s Name
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ASSESSING PRACTICE INITIATIVES AND LEADERSHIP APPROACHES 2
Abstract
The synthesis of the article is bridging the gap between healthcare practice programs and
leadership approaches that create financial returns, which optimize patient care delivery.
Importantly, sufferer no-show affects care delivery to patients, wastage of hospital resources, and
longer waiting times for patients. Thus, various leadership approaches such as situational,
contingency, and relationship assist in minimizing patient no-shows, which maximizes resources
utilization in the medical facility.

ASSESSING PRACTICE INITIATIVES AND LEADERSHIP APPROACHES 3
Assessing Practice Initiative and Leadership Approaches
There are various practice programs and leadership approaches that may influence the
financial returns on capital invested in optimizing patient care delivery. Notably, most of these
practice initiatives and leadership techniques aim at minimizing no-shows that adversely affect
the delivery of health care services to sufferers. Besides, it causes medical facilities to incur
losses that can be avoided, or managed if the schedules are respected. Thus, practice programs
such as lean have been widely adopted in health care settings as it offers an effective
management system. It seeks to enhance a hospital’s capacity to provide quality and safe health
care services, while simultaneously reducing costs.
The change theory is one of the most effective leadership approaches that assess the
impact of investing in a medical facility. Normally, the technique depends on a common
structure of social-performance measures for funds invested in a certain industry, such as the
medical care sector. Thus, the approach ensures that no-shows are limited or prohibited in
medical care facilities as a lot of funds are invested in taking medical specialists’ time.
Increase of Medical Costs and Interruption of Patient Care
A study by Shah et al. (2016) suggested that patients not showing up for scheduled
appointment increases medical costs, interruption of sufferer care, and wastage of hospital
resources that minimize the firm’s productivity. To reduce or eradicate no-shows and maximize
financial returns, a sufferer service coordinator in a busy-scheduled facility should make
reminder telephone calls to patients seven days before their appointment. Kumthekar and
Johnson (2018) revealed that since no-shows at booked appointments led to adverse financial
implication and wastage of time, phone calls can help to notify patients regarding a pre-engaged

ASSESSING PRACTICE INITIATIVES AND LEADERSHIP APPROACHES 4
commitment before the due date. Typically, these phone calls may involve automated phones to
patients who scheduled an appointment, and medical staff text messaging or calling.
A Decrease in Care Quality and Longer Waiting Times
A study conducted by Mohamed et al. (2016) mentioned that sufferer no-shows to
schedules might upshot a decrease in care quality, and longer waiting times. The latter further
suggests that longer waiting times adversely upset health outputs, especially chronic sufferers.
To resolve this, medical facilities may adopt situational approaches that will ensure that the
facility adopts smoothly to any cases of patient no-shows. This can be achieved by implementing
a system where all unattended appointments are refilled in the morning prior to the hospital,
forming a list of urgent care patients. As a result, any losses that the medical facility may have
incurred due to sufferer no-shows is managed, which maximizes on its returns.
The Link between Sufferer No-show and Their Visits to the ED
Samuel et al. (2015) focused on establishing a positive connection between sufferer no-
shows and their number of visits at the emergency room. The former further suggests that high
patient no-show rates may result in an increase of ED visits. Thus, nurses are advised to help
patients in understanding their state of health, and the need of attending to check-ups as
scheduled to avoid severe health problems. As a result, nurses may use relationship techniques
to focus on the performance of a patient, and their will to fulfill scheduled appointments.
Importantly, this approach requires the nurse to have high moral and ethical standards that
consider a patient’s health.
The Effect of Missed Appointments to Racial and Ethnical Minorities

ASSESSING PRACTICE INITIATIVES AND LEADERSHIP APPROACHES 5
Shimotsu et al. (2016) noted that missed schedules result in negative outputs, which upset
ethnical and racial subgroups. The study further suggests that patient no-show appointments lead
to unproductive utilization of clinicians’ time, leading to loss of medical care funds. Importantly,
no-show rates are higher in a clinical setting where care is administered to ethnic and racial
minorities. As a result, medical facilities may use management approaches to focus on the role of
nurses of supervising the performance of patient attendance to appointments. Hence, nurses are
advised to make medical care less complex for such patients, which will encourage them to
attend scheduled appointments. This will ensure that the medical facility maximizes on its
resources as patients attend to simple and less complex check-ups and medical procedures.
According to Mallow et al. (2015), the missed appointment can be minimized by medical
facilities by creating mobile applications that allow sufferers to access the mobile healthcare
clinic. Thus, the applications may contain medical history and current status of a patient’s health,
which can be easily be retrieved by the mobile clinic from the hospital’s database. The study
further suggests that the development of SMART as a health practice model will ensure the
establishment of sophisticated nursing interventions that are intended to enhance quality care
delivery. Thus, the hospital may use participative approaches to ensure that sufferers use video
teleconferencing structures, which are tailored to educate them regarding medication, monitoring
of blood glucose, and nutrition.
Patient-testing and Delay of Disease Detection
Kheirkhah et al. (2016) mentioned that no-shows delayed patient testing, which may
endanger his or her lie due to delayed detection of illnesses. The study suggested that sufferer
no-shows affect the planning of medical resources, which affects the quality of care delivered
and increases healthcare costs. To improve healthcare systems, a hospital may focus on

ASSESSING PRACTICE INITIATIVES AND LEADERSHIP APPROACHES 6
contingency theories that prioritize specific health variables connected to the medical
environment. These may include reminder procedures, minimizing overbookings, and
penalization, which will ensure maximum utilization of hospital resources while minimizing
additional costs.
The Link between Sufferer’s Probability of No-show and Use of Calculated NSPF
Hwang et al. (2015) focused on determining the connection between a sufferer’s
probability of no-show for scheduled appointments and resulting clinical outputs with the use of
calculated NSPF. Besides, no-show cases were identified to be more rampant where a hospital
had poor care management, which increased the number of sufferers at the ED. Thus, a hospital
may use management approaches to restructure its leadership system by focusing on the
performance of medical staff, and the role of supervision. As a result, health personnel who were
effective in delivering quality care were awarded, while non-performing were reprimanded. This
would improve care management at the hospital that will, in turn, reduce sufferer no-show rates,
while increases resources utilization at the facility.
The research studies focused on patient no-shows affected the quality of care, elevated
medical costs, increased longer waiting times, and wastage of hospital resources. In spite of most
studies revolving around the effects of sufferer no-show, they focus on independent themes and
how healthcare practice programs and leadership approaches enhance financial returns.
Importantly, most of the programs and leadership techniques are based on the theory of change
that analyzes investments and outcomes made on a medical facility.

ASSESSING PRACTICE INITIATIVES AND LEADERSHIP APPROACHES 7
References
Hwang, A. S., Atlas, S. J., Cronin, P., Ashburner, J. M., Shah, S. J., He, W., & Hong, C. S.
(2015). Appointment “no-shows” are an independent predictor of subsequent quality of
care and resource utilization outcomes. Journal of general internal medicine, 30(10),
1426-1433.
Kheirkhah, P., Feng, Q., Travis, L. M., Tavakoli-Tabasi, S., & Sharafkhaneh, A. (2015).
Prevalence, predictors and economic consequences of no-shows. BMC health services
research, 16(1), 13.
Kumthekar, A., & Johnson, B. (2018). Improvement of appointment compliance in an
underserved lupus clinic. BMC health services research, 18(1), 610.
Mallow, J. A., Theeke, L. A., Long, D. M., Whetsel, T., Theeke, E., & Mallow, B. K. (2015).
Study protocol: mobile improvement of self-management ability through rural
technology (mI SMART). Springerplus, 4(1), 423.
Mohamed, K., Mustafa, A., Tahtamouni, S., Taha, E., & Hassan, R. (2016). A quality
improvement project to reduce the ‘No Show’rate in a pediatric neurology clinic. BMJ
Open Quality, 5(1), u209266-w3789.
Samuels, R. C., Ward, V. L., Melvin, P., Macht-Greenberg, M., Wenren, L. M., Yi, J., ... & Cox,
J. E. (2015). Missed appointments: factors contributing to high no-show rates in an urban
pediatric primary care clinic. Clinical Pediatrics, 54(10), 976-982.
Shah, S. J., Cronin, P., Hong, C. S., Hwang, A. S., Ashburner, J. M., Bearnot, B. I., ... &
Kimball, A. B. (2016). Targeted reminder phone calls to patients at high risk of no-show
for primary care appointment: a randomized trial. Journal of general internal
medicine, 31(12), 1460-1466.

ASSESSING PRACTICE INITIATIVES AND LEADERSHIP APPROACHES 8
Shimotsu, S., Roehrl, A., McCarty, M., Vickery, K., Guzman-Corrales, L., Linzer, M., & Garrett,
N. (2016). Increased likelihood of missed appointments (“no shows”) for racial/ethnic
minorities in a safety net health system. Journal of primary care & community
health, 7(1), 38-40.