Log

Missed appointment log - JCI ACC.6, all healthcare settings (international)

A log for tracking missed patient appointments, detailing clinical risk, contact attempts, follow-up actions, and documentation of the process.

Fill it in online - free, no account needed. 19 questions.

What it is for

This template provides a structured way to log and manage missed patient appointments.

The full question list

1. Appointment Details

  1. Date and time of the missed appointment *
  2. Patient reference number or identifier is recorded *
  3. Scheduled service or clinician is identified *
  4. Clinical risk level associated with this missed appointment is assessed and recorded *

2. Contact Attempts

  1. Date and time of first contact attempt is recorded *
  2. Method of first contact attempt is recorded (e.g., phone call, SMS message, email, letter) *
  3. Outcome of first contact attempt is clearly documented *
  4. Second contact attempt was made if the first was unsuccessful *
  5. Date and time of second contact attempt is recorded (if applicable)
  6. Method of second contact attempt is recorded (if applicable)
  7. Outcome of second contact attempt is clearly documented (if applicable)

3. Follow-up Actions

  1. New appointment was successfully booked for the patient *
  2. Date and time of new appointment is recorded (if booked)
  3. Referring clinician was informed of the missed appointment (if applicable) *
  4. Details of information provided to referring clinician are documented (if applicable)
  5. Any other actions taken are recorded (e.g., patient education, referral to social services)

4. Record and Review

  1. Name of staff member completing this log entry is recorded *
  2. Date and time this log entry was completed is recorded *
  3. Signature of staff member completing this log entry *

References

How the score works

The score is the share of scored questions that pass. N/A is left out of the score; text, dates and signatures are recorded but not scored. A completed template is a record of what you checked; it is not an inspection by a regulator or an accreditation body.

Questions

Why is logging missed appointments important?

Logging missed appointments helps identify potential patient safety risks, ensures continuity of care, and provides data for improving patient engagement and service delivery.

What is 'clinical risk level'?

Clinical risk level refers to the potential negative impact on a patient's health or well-being due to a missed appointment, ranging from low to critical based on the patient's condition and the nature of the missed service.