Decreasing No Show Rates in a Dental Clinic at a Federally Qualified Health Center Following Referral from a Medical Clinic

The prevalence of oral disease is disproportionately high among people with low income, reflecting lack of access to dental care. Federally Qualified Health Centers (FQHC) benefit communities they serve by providing affordable dental care; however, many clinics face an overwhelming amount of no-show appointments. The objective of this program is to expand clinical interprofessional training experiences at partnering FQHCs to decrease no show rates in dental clinics.

In this study, dental and medical students see patients together in the medical clinic of the FQHC in King County, WA. Dental students teach medical students how to conduct oral health screenings and when to refer to the dental clinic. Medical students and staff at the FQHC gather data on referrals and follow-up at the co-located dental clinic to determine who presents for dental appointments. Initially, patients needing dental care were responsible for following up on their own with the dental clinic. Low follow-up rates resulted in adjusting the referral system to using a warm hand off. Students now walk patients to the dental clinic to schedule the recommended appointment.

From the summer of 2016 until December 2018, 222 patients were seen by medical and dental students. From 2016 to August of 2018 when the old referral method was used, 184 patients were seen by medical and dental students, and of those referred to the dental clinic 27% showed for their dental appointment. 80% of those who made a dental appointment showed for the appointment. From August 2018 to December 2018, during the pilot phase of the new referral system, 67% of those who were referred to the dental clinic showed for an appointment. 100% of those who made a dental appointment showed for the appointment.

These findings suggest the new referral system increased patient compliance with appointments. Interprofessional collaboration, co-located care, and warm hand off referrals have the potential to decrease no show rates in FQHCs. Clinics that serve low-income adults can incorporate such practices to improve no show rates and facilitate access to dental care. This project is funded by the Health Resources and Services Administration under grant number D85HP20045.