Improving pediatric appointment keeping with reminders and reduced response requirement.

A children’s hospital mailed and phoned families before every check-up. They also mailed a free parking pass.

The team tracked five doctors for one year. They counted kept and broken appointments each month.

A multiple-baseline design showed when each doctor started the package.

Kept visits jumped from a large share to a large share. Broken visits fell from a large share to a large share.

The gains stayed high for the full year. All five doctors saw the same change.

Pear et al. (1984) got the same win by simply giving sooner dates. They cut the wait from three weeks to one week. Billings et al. (1985) kept the long wait but added reminders and a parking pass. Both teams slashed no-shows.

Simcoe et al. (2024) and Simacek et al. (2017) moved the idea online. They used telehealth coaching to reach families who could not drive to clinic. The goal—more kids served—matches, but the tool is now a screen instead of a stamp.

Bigby et al. (2009) used a low-cost package like this one. They added staff training and a supply box to cut medicine errors. The setting and problem differ, but the lesson is the same: small, cheap aids plus clear cues fix big system gaps.

You can copy the 1985 package today. Mail or text a reminder, then drop a parking code or bus voucher. One stamp or click can save you hours of reschedule calls and open slots for other kids.