Addressing Loss of Low Risk Obstetric Patients to Postpartum Care in an Inner City Hospital [11E

Abstract

INTRODUCTION: Postpartum appointments after discharge from uncomplicated deliveries are integral to building patient-physician relationships, screening for complications, decreasing emergency department visits, and preventing readmissions. At Temple University Hospital, patients were responsible for scheduling their own follow-up appointments after delivery. METHODS: A retrospective chart review was performed to evaluate the rate of patient initiated postpartum follow up. A new approach to improving attendance at postpartum visit was instituted using an electronic scheduling system at the time of discharge. Patient return rates were prospectively monitored comparing patients using the old and new system. RESULTS: In 2012-2013, 62.5% of patients of patients attended self-initiated follow-up appointments. In 2013-2014, 23% of patients had their follow-up appointments scheduled through the electronic system and 62% of these women attended their follow-up appointments. In the same year, 84% of patients attended self- initiated follow-up appointments and the overall attendance rate was 63% of postpartum patients. In 2014-2015, 62.5% of patients had their follow-up appointments scheduled through the electronic system. Of these, 48% of patients attended their follow-up appointments compared to 88% who attended appointments they scheduled themselves, with an overall follow up rate of 56.5%. CONCLUSION: Implementation of a model where postpartum appointments are scheduled through the electronic system has not increased the rates of follow up for low risk obstetric patients. Future plans include a pilot study of scheduling postpartum appointments during a term prenatal visit and contacting patients the week of their scheduled appointments to remind them of the appointment date and time.