1. How many patients do not make an appointment with the Sleep Clinic after referral by their Primary Care Physician? Ingrid Hsiung, Bob Song, Asha Nookala, MD, Abid Bhat, MD UMKC School of Medicine, Truman Medical Centers Obstructive sleep apnea (OSA) currently affects 18 million Americans and carries a higher prevalence in populations of low socioeconomic status, similar to the patient population at Truman Medical Center (TMC). This disease commonly manifests as snoring, daytime fatigue, and even cardiovascular disease. TMC patients with suspected OSA can only obtain a proper work up from the Sleep Clinic after Primary Care Physician (PCP) referral to the sleep clinic. INTRODUCTION Patients who failed to arrange appointments were surveyed via telephone interviews; each patient was contacted a maximum of two times—once in the morning and once in the evening—to be asked a set series of questions: [1] whether they were contacted for an appointment, [2] why they chose not to make a clinic appointment, [3] patient satisfaction on a scale from 1-10 regarding the appointment-making process, [4] suggestions for improvement. METHODS RESULTS 40% (n=79) of all referred patients (n=200) did not successfully schedule an appointment, meaning that 40% of all PCP referrals to the Sleep Clinic went unfulfilled. 53% of patients (n=42) were unable to be contacted, suggesting a failure of communication after leaving the office. Independent variables such as insurance, gender, race, and referring clinic were assessed and found to have little impact on appointment compliance. Although some patients did not show initiative to call and schedule an appointment themselves, 24% (n=19) of patients who failed to self-schedule appointments were successfully contacted by the Sleep Clinic to arrange appointments prior to the survey. This shows promise for the Sleep Clinic reminding patients to schedule appointments as an avenue to increase successful referral rates. SUMMARY FUTURE DIRECTIONS After gathering the data, it became evident that the follow-up rates to the sleep clinic were less than optimal. Patients were clearly taking the steps to visit with their primary care providers but were not taking the necessary steps in seeing the appropriate specialists. The next step in improving outcomes would be to introduce an intervention, something that is actually already being implemented. A brochure was created with important information regarding sleep and the sleep clinic itself, emphasizing the importance of keeping appointments on health. This brochure was given to distribute in all the various primary care clinics in Truman Medical Center. Data gathering and analysis for the impact of the brochure is currently ongoing. Further ideas include training the primary care providers to better educate patients regarding the importance of sleep health and compliance with appointments as well as new methods to remind patients, whether online or physical. REFERENCES 1)Strohl, Kingman P. "Overview of Obstructive Sleep Apnea in Adults." UpToDate. Ed. Nancy Collop and Geraldine Finlay. N.p., 16 Nov. 2015. Web. 28 Feb. 2016. http://www.uptodate.com/contents/ overview-of- obstructive-sleep-apnea-in - adults?source=search_result&search=obstructive+ sleep+apnea&selectedTitle=1~150 http://www.uptodate.com/contents/ overview-of- obstructive-sleep-apnea-in - adults?source=search_result&search=obstructive+ sleep+apnea&selectedTitle=1~150 2)Kline, Lewis R. "Clinical Presentation and Diagnosis of Obstructive Sleep Apnea in Adults." UpToDate. Ed. Nancy Collop and Geraldine Finlay. N.p., 23 Mar. 2016. Web. 28 Mar. 2016...