Health Policy: PICOT Question Development

Subject: Nursing
Pages: 2
Words: 599
Reading time:
3 min
Study level: College

When timely noticed and resolved, public health issues can dramatically improve well-being nationwide, and nursing practitioners are capable of achieving these improvements. For instance, observation of patients’ activities in my practicum site, the East Orange Hospital Clinic, revealed the tendency to skip the follow-up appointment with the doctor. Such behavior has severe outcomes for the clients and the quality of services; thus, it is a problem that requires a resolution (Dantas et al., 2018). Furthermore, the beneficiaries with the highest non-attendance probability represent the impoverished population, and exploring their specific characteristics is necessary to make a practice change. This paper aims to explain the problem of the increased number of skipped follow-up visits among the impoverished population in the PICOT terms and develop a relevant research question.


The identified problem is prevalent among the East Orange Hospital Clinic beneficiaries who represent the impoverished population; therefore, this specific group must be studied for further intervention development. Indeed, research articles about their behaviors, socioeconomic characteristics, and lifestyles help conclude necessary to understand how such patients’ decision-making can be influenced. Impoverished population representatives tend to prioritize saving finances and affording only the minimum of healthcare services even if their conditions require more complicated interventions (Ofei-Dodoo et al., 2019). Furthermore, such beneficiaries frequently experience language barriers in communication with doctors, lack sufficient education, and have limited access to a healthy lifestyle and nutrition.


Intervention for skipping follow-up visits must address the population’s key characteristics and be based on the clinical practice change. The problem is tied to the clinical practice approaches such as communication with patients, and the solution must include updates in doctors’, nurses’, and administrators’ actions (Williamson et al., 2021). Indeed, physicians can improve patient education through teaching how crucial it is to attend the appointment; administration can develop reminder practices. Nursing practitioners can also adjust their communication to tailor the importance of follow-up visits and ensure that the client understands.


Compared to the outlined intervention, another solution can be no actions taken on the practicum site’s workers. The probability that patients’ conditions would worsen and force them to re-visit the hospital is relatively high and can be positioned as their responsibility. Although not encouraging them to attend the follow-up appointment does not violate any policies, it is ethically incorrect because the lack of action goes against the principle of non-maleficence (Dantas et al., 2018). In such a case, the number of missing follow-up visits would decrease as the clients will learn through the experience and share it with their friends and family.


The outcome of active intervention performed by physicians, practitioners, and administrators is the behavioral change among the impoverished population representatives. Indeed, if the number of skipped appointments decreases and patients start to act more responsible towards their health, the problem can be perceived as solved (Fandino, 2019). The East Orange Hospital Clinic operates through an electronic record system, and data to analyze would be retrieved from there to track if the number of attended follow-up visits increased.


Timeframe to realize the initiative and achieve notable results depends on the number of follow-up visits assigned by physicians to their impoverished patients. The selected population represents the significant number of beneficiaries, and a relatively short time segment can be taken for revealing the attendance tendencies (Fandino, 2019). The average period, such as three months, is appropriate for checking if the percentage of missed appointments changed.

The PICOT question is: “In impoverished patients, what is the efficiency of treatment if they are encouraged to attend the follow-up visit, compared to no intervention within three months?”


Dantas, L. F., Fleck, J. L., Oliveira, F. L. C., & Hamacher, S. (2018). No-shows in appointment scheduling–A systematic literature review. Health Policy, 122(4), 412-421. Web.

Fandino, W. (2019). Formulating a good research question: Pearls and pitfalls. Indian Journal Of Anaesthesia, 63(8), 611. Web.

Ofei-Dodoo, S., Kellerman, R., Hartpence, C., Mills, K., & Manlove, E. (2019). Why patients miss scheduled outpatient appointments at urban academic residency clinics: A qualitative evaluation. Kansas Journal of Medicine, 12(3), 57. Web.

Williamson, A. E., McQueenie, R., Ellis, D. A., McConnachie, A., & Wilson, P. (2021). ‘Missingness’ in health care: Associations between hospital utilization and missed appointments in general practice. A retrospective cohort study. PloS One, 16(6), e0253163. Web.