Improving follow-up in hospitalised children
- Gary L McPhail,
- Mathew D Ednick,
- Matthew C Fenchel,
- Rhonda VanDyke,
- Amrita Chima,
- Raouf S Amin,
- Michael Seid
- Division of Pulmonary Medicine, University of Cincinnati, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
- Correspondence to Dr Gary L McPhail, Division of Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, ML 2021, 3333 Burnet Avenue, Cincinnati, OH 45229, USA;
- Accepted 18 January 2010
- Published Online First 27 May 2010
Objective To improve the clinic follow-up rate of paediatric inpatients in a tertiary care hospital.
Patients and methods Inpatients who received pulmonary consultations from July 2007 to June 2008 at Cincinnati Children's Hospital Medical Center were eligible for this quality-improvement project. Multiple interventions were introduced to improve follow-up in our subspecialty clinic. A χ2 test for association was used to assess the dependence between the clinic follow-up rate and the type of care coordination intervention. We hypothesised that generalisable care coordination interventions would result in improvements.
Results Two hundred and eleven patients were included. Two interventions were independently associated with improvements in the hospital follow-up rate. When a reminder to follow-up in the pulmonary clinic was inserted into the hospital discharge summary (partial intervention), the clinic follow-up rate improved from 27% to 55%. When the follow-up appointments were made for the families, with the appointments' noted in the discharge summaries, and automated appointment reminder phone calls were provided (full intervention), the follow-up rate improved further from 55% to 80%. The full intervention, when compared with no intervention, improved the clinic follow-up rate from 27% to 80%.
Conclusion Establishing clinic appointments for patients and providing appointment reminders increases the hospital follow-up rate for hospitalised children in outpatient clinics.
- care coordination
- healthcare delivery
- hospital follow-up
- subspecialty care
- healthcare quality improvement
GLM had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.
Funding This study was funded internally. There was no sponsor involvement in the design of this study or in the writing of this manuscript for publication.
Competing interests None.
Provenance and peer review Not commissioned; externally peer reviewed.