Patient-Centeredness is the IOM Domain That Will Help This Patient Adhere to Appointments
Patient-centeredness is the Institute of Medicine quality domain that directly addresses appointment adherence by focusing on individual barriers, preferences, and needs that prevent patients from attending scheduled visits. 1
Why Patient-Centeredness is the Answer
Patient-centered care specifically targets the root causes of missed appointments by:
- Addressing individual barriers to care such as scheduling conflicts, transportation issues, work constraints, childcare needs, and personal preferences that commonly prevent appointment attendance 1
- Implementing automated reminder systems (phone calls, text messages, electronic notifications) that significantly reduce no-show rates 1
- Offering flexible scheduling options including clustering diabetes visits at convenient times, providing group visits, or offering multiple appointment options that align with patient needs 1
- Identifying and addressing psychosocial barriers such as depression, work conflicts, or transportation problems that lead to attendance issues 1
The Evidence Supporting Patient-Centeredness
The American Diabetes Association explicitly recommends patient-centered approaches to improve appointment adherence, emphasizing that care must be tailored to individual patient circumstances rather than applying a one-size-fits-all approach 2. Research demonstrates that previsit phone calls to diabetic patients with scheduled appointments optimize patient knowledge, self-management goals, and help ensure completion of recommended services, resulting in more patients receiving regular care 3.
Patient-centered systems that match therapy with patient representations, expectations, and acknowledge the constraints of everyday life achieve the best adherence outcomes 4. This approach moves beyond exclusively considering the physical burdens of disease to include the personal and social significance of the patient's experience 4.
Why Other Options Are Incorrect
- Timeliness refers to reducing wait times and delays in receiving care, not improving patient attendance at scheduled appointments 2
- Efficiency focuses on avoiding waste and optimizing resource utilization in healthcare delivery 2
- Safety addresses preventing harm and medical errors during care delivery 2
None of these domains specifically target the patient-level factors (scheduling conflicts, transportation, work constraints, personal preferences) that cause missed appointments.
Common Pitfalls to Avoid
Do not assume that simply scheduling more appointments will improve adherence—without addressing the underlying patient-centered barriers (transportation, work schedules, childcare, understanding of importance), patients will continue to miss visits 1. The key is implementing specific patient-centered interventions like automated reminders and flexible scheduling options that remove obstacles to attendance 1.