SAT130 Examining Rates Of Post-hospital Discharge Follow-up In An Endocrinology Clinic

Abstract

Abstract Disclosure: T. Khan: None. A.M. Kumar: None. A. Champion: None. K.E. Izuora: None. Introduction: Outpatient follow up following hospital discharge is a critical factor in improving overall health outcomes especially among patients with chronic medical conditions. Previous research has demonstrated improved patient outcomes and lower readmission rates in patients with outpatient follow up after hospital discharge. In this single center QI project, we sought to understand the follow-up rate and the reasons for not following up among our patient population. Methods: This study is a root cause analysis following the Plan-Do-Study-Act cycle. All the patients seen by the UNLV inpatient endocrinology consult service in June and July 2022 were recorded. Patients discharged to hospice or discharged after July 31, 2022 were excluded from the study. After December 1, 2022 the number of patients that followed up at UNLV endocrinology clinic from the list was recorded. All patients that met inclusion criteria for the study and did not follow up at UNLV endocrinology clinic were contacted by phone and reason for not following up was recorded. Results: Over the 2 months of recruitment, 74 patients were consulted on by the endocrinology service and 67 met study inclusion criteria. From this group, only 13 patients had established follow-up care at the UNLV endocrinology clinic. From the remaining 54 patients, 5 had died. The 49 remaining patients who met criteria for the study but did not follow up were contacted via telephone (3 attempts). Of this, 8 patients either did not answer phone calls three separate times or did not have an active listed phone number. Of the 41 patients contacted, the most frequent reason for not following up was inability to contact the clinic (6 patients, 14.6%), unawareness of need for follow-up (5 patients, 12.2%), prior established endocrinology care outside of UNLV (5 patients, 12.2%), no indication for follow-up (5 patients, 12.2%), and PCP managing the condition (5 patients, 12.2%). Of the remaining, 4 patients were not instructed to follow up, 3 patients had insurance not accepted at the UNLV endocrinology clinic, 2 patients were unable to get a convenient appointment and 2 patients established care at other endocrine clinics. The following reasons for not following up were given by one patient per category: leaving the city, discharge to prison, appointment canceled by the clinic, and refusing to answer any questions. Conclusion: From these responses, we can formulate methods to improve clinic follow-up after clinic discharge. The primary method to improve clinic follow-up after hospital discharge is to improve ease of contact with the clinic such as ensuring phone lines are adequately attended. An additional measure would be to stress need for follow-up at time of hospital discharge in addition to having printed instructions for clinic follow-up in the discharge paperwork. Presentation: Saturday, June 17, 2023