Date of Graduation

Spring 5-14-2020

Document Access

Project/Capstone - Global access

Degree Name

Master of Science in Nursing (MSN)


Clinical nurse leaders (CNLs) are change agents who “improve quality, cost, or efficiency of healthcare delivery” (Noles, Barber, James, & Wingo, 2019, p. 307). The CNL of a breast cancer clinic recognized the significant impact the high no-show rate of breast cancer screening appointments had on patient outcomes and staff productivity. After conducting a microsystem assessment, the CNL organized a meeting with key stakeholders to identify potential interventions to address this issue. Concerns regarding the efficiency and effectiveness of the current telephone reminder system were raised, indicating an area for improvement. The CNL facilitated the team in researching evidence-based practices to identify a better method to remind patients of their appointments. After conducting the literature review, a text-based reminder system proved to be the most effective, efficient, and economical (Vidal, Garcia, Benito, Binefa, & Moreno, 2014). The aim of this quality improvement project is to reduce the breast cancer screening no-show rate by 2% to enhance the quality of life of patients, decreasing cancer mortality through early detection of breast cancer. During this time, the Covid-19 pandemic hit, preventing the progression and changing the scope of the project where implementation and evaluation of the intervention could not be accomplished. However, the CNL continued communicating and collaborating with staff members remotely to develop a detailed plan with the hopes of the team utilizing components that will work for them. The CNL was driven by professional values and core competencies to engage staff, cultivating an environment that supports change.