Increasing Primary Care Physician Follow-Up Appointments After Hospitalization

Abstract

Waimanalo Health Center (WHC) in Hawaii has a problem with their patients following up with their primary care providers (PCPs) after discharge from the hospital, leading to a large number of 30-day readmissions. The purpose of this evidence-based project (EBP) was to increase WHC patients’ follow-up appointments with their PCP within 2 to 3 days of discharge from the hospital or no later than 7 days after discharge. An EBP was implemented from October 10, 2018 through January 10, 2019, at Adventist Health Castle medical center (AHC) on medical, telemetry, and surgical floors to increase WHC patients’ scheduling and attending follow-up appointments with their PCPs within 7 days of discharge. The project consisted of having all discharging nurses prompt patients to call physically and schedule their follow-up appointments with their PCPs prior to being discharged from the hospital; patients received a redesigned larger appointment card with their appointment dates and times, along with information on the importance of following up with their PCPs. This verbal prompt and appointment card were added to AHC’s existing discharge, which consisted of patient-centered discharge packets and follow-up phone calls. The number of appointments made by patients to schedule their follow-up appointments with their PCPs decreased from 70% to 59%, and the appointments made within 7 days had a slight decrease from 26.9% to 26%. Findings indicated 14 patients made follow-up appointments within 7 days of discharge with no readmissions and a readmission rate of 0%; 18 patients had follow-up appointments scheduled within 30 days of discharge with 2 readmissions during this period and a readmission rate of 11.1%; and 22 patients did not schedule follow-up appointments after discharge, with 7 being readmitted within 30 days, a readmission rate of 31.8%. In conclusion, adding the EBP and having patients schedule their follow-up appointments prior to being discharged from a hospital had no effect on increasing the number of patients who scheduled follow-up appointments. However, evidence showed that fewer patients who scheduled a follow-up appointment within a month after discharge were readmitted to the hospital.