SHM Converge Scientific Abstract ePoster Gallery-Improving Post-Hospitalization Follow Up

Pdf Summary

The project addressed delays and confusion in arranging specialty follow-up appointments for patients after hospital discharge. Since the hospital’s switch to Epic in December 2021, providers used several inconsistent methods to request follow-up, making the process unclear and potentially delaying care.<br /><br />The team aimed to:  <br />1) understand how follow-up appointments were requested and scheduled,  <br />2) measure how long patients waited for specialty clinic follow-up, and  <br />3) create a standardized tool to guide providers.<br /><br />To gather data, the team reviewed discharges from two hospitalist units in June and July 2023. They examined discharge summaries, order sets, and after-visit summaries to identify ambulatory referral orders. Encounters without such referrals were excluded. For included cases, they recorded the clinic requested, desired timeframe, actual appointment date, and relevant patient factors. The team also interviewed schedulers to learn what information they needed to schedule patients efficiently.<br /><br />Out of 106 encounters reviewed, 33 included specialty clinic referrals and were analyzed. The average wait time for follow-up was 45.7 days, with a wide range from 1 to 185 days.<br /><br />Scheduler interviews revealed common barriers to timely scheduling: missing diagnoses, unclear desired timing for follow-up, and lack of clarity about which clinician the patient should see. Schedulers also said it helps when providers place follow-up requests early during the hospital stay.<br /><br />Based on these findings, the team developed a job aid to standardize the appointment request workflow. The initiative showed that such a tool is feasible, and future work should assess whether it improves the speed and consistency of post-hospital follow-up scheduling.

Asset Subtitle

Timothy R. Ford

Meta Tag

Author List Amber Balzer, Carolyn Marcelo, Kimberlee Ketchersid, Megan Gosnell, Timothy R. Ford

Category Innovations

Concept Follow-up Appointment

Concept Time to Follow-Up

Concept Ambulatory Referral Order

Concept Diagnosis

Concept Timeframe

Distinguished Non-Finalist

Presenter Organization VCU Health

Presenting Author Timothy R. Ford

Track Transitions of Care

Keywords

specialty follow-up

hospital discharge

appointment scheduling

Epic EHR

ambulatory referral

wait time

workflow standardization

scheduler interviews

post-discharge care

job aid

Follow-up Appointment

Time to Follow-Up

Ambulatory Referral Order

Diagnosis

Timeframe