3:54 PM Abstract No. 78 New clinic workflow improves compliance for routine percutaneous nephrostomy tube exchanges

Abstract

To examine the effect of a clinic workflow intervention on follow-up for routine percutaneous nephrostomy tube (PCN) exchanges. An intervention consisting of automated electronic tracking for all PCN placements and exchanges followed by phone call reminders to schedule a follow-up exchange 60 days post procedure was introduced on March 19, 2019. All PCN exchanges performed from March 19, 2018 to August 14, 2019 were identified through a local electronic database search to assess the impact of intervention as a quality improvement project. Basic demographic information, and procedure details were collected. Routine follow-up at our institution is recommended every 90 days. The exchange rates within 90 days were compared between groups using a Chi-squared test. A total of 224 PCN exchanges were performed preintervention and 71 PCN exchanges were performed postintervention. Preintervention, 134/224 (59.8%) were exchanged within 90 days compared to 54/71 (76.1%) exchanged within 90 days postintervention. The remainder had delayed follow-up due to loss to follow-up or scheduling delays. Postintervention, there is a significantly improved rate of compliance for PCN exchanges within the recommended 90 days at our institution (P = 0.013). Automated tracking and phone call follow-up at 60 days post procedure is a simple and effective intervention that can improve compliance for routine PCN exchanges and reduce the number of patients that are lost to follow-up.