Patient-Centeredness is the IOM Domain That Will Help This Patient Adhere to Appointments
The answer is A - Patient-Centeredness. This IOM quality domain directly addresses appointment adherence by focusing on care that is respectful of and responsive to individual patient preferences, needs, and values, including scheduling preferences and barriers to attendance 1.
Why Patient-Centeredness is the Correct Answer
Patient-centeredness encompasses several key elements that directly impact appointment adherence:
Addressing individual barriers to care: Patient-centered approaches identify and respond to specific obstacles preventing patients from attending appointments, such as scheduling conflicts, transportation issues, work constraints, or personal preferences 1.
Shared decision-making and engagement: When patients feel their preferences are valued and they participate in scheduling decisions, adherence improves significantly 2, 3.
Systematic follow-up and reminders: Patient-centered systems include automated reminders to patients about upcoming appointments, which has been shown to reduce no-show rates 1.
Flexible scheduling options: Practice changes such as clustering diabetes visits at specific times convenient for patients, offering group visits, or providing multiple appointment options align with patient needs 1.
Why the Other Options Are Incorrect
Timeliness (Option B) refers to reducing wait times and delays in receiving care once the patient is present, but does not address the fundamental issue of getting the patient to show up for appointments 1.
Efficiency (Option C) focuses on avoiding waste and optimizing resource use within the healthcare system, not on patient attendance behaviors 1.
Safety (Option D) concerns preventing harm and medical errors during care delivery, which is irrelevant to appointment adherence 1.
Evidence-Based Strategies for Implementation
The most effective patient-centered interventions for improving appointment adherence in diabetes care include:
Automated reminder systems: Phone calls, text messages, or electronic notifications sent to patients before scheduled appointments significantly improve attendance 1.
Assessment of patient preferences: Directly asking patients about their scheduling needs, barriers to attendance, and preferred appointment times 3, 4.
Addressing psychosocial barriers: Identifying issues such as transportation problems, work conflicts, childcare needs, or depression that may prevent attendance 1.
Patient education and engagement: Ensuring patients understand the importance of regular monitoring and feel invested in their care plan 1.