Reducing the No-Show Rate in Immunization Clinics at a Local Health Department: Lessons Learned


Impact Statement: 
This 10-county District health department improved the processes of immunization clinic scheduling, preparation and follow-up and reduced the number of “no shows” , leading to greater efficiency and capacity. The improved process and staff training were then standardized across the 10 counties.

The overall no-show rate for immunization clinics at District Health Department (DHD) #10 was too high, leading to inefficiencies in clinic effectiveness. A quality improvement (QI) process was used to study the issue, collect data, determine possible solutions, test the solutions, implement strategies, and continue to monitor the no-show rate. The fishbone technique helped the team understand more about why clients did not keep appointments. The IS map illustrated the scheduling process for immunizations and highlighted the differences among the 10 counties. Techniques were tested to improve the no-show rate, including the use of incentives, collecting best methods to contact clients, and making reminder calls. No-show data were collected before, during, and after the QI project. Findings led to a standardization of the immunization clinic process and staff training across all 10 counties.

Organization that conducted the QI initiative: 
District Health Department #10

Oleniczak, S. Public Health Quality Improvement Exchange. Reducing the No-Show Rate in Immunization Clinics at a Local Health Department: Lessons Learned. Thu, 12/27/2012 - 15:17. Available at Accessed June 22, 2024.

Submission Status: 
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Submitted by kmunsey on

It is good to see that you had data difficulty initially with regards to your measurable outcomes. We too struggled with our project and learned that sometimes you do have to explore other ways to collect data in order to get true measurable outcomes. NIce project.

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