Evaluation of Clinical No-Show Rates in the Setting of an Outpatient Internal Medicine Residency Clinic

2020 ◽  
pp. 12-17
Author(s):  
Michael Soos ◽  
Alexander Cobb ◽  
Parag Patel ◽  
Hemalata Mandiga ◽  
Amit Ghose ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Primary Care ◽  
Confidence Interval ◽  
Text Message ◽  
Phone Call ◽  
Primary Care Clinics ◽  
Phone Calls ◽  
Secondary Endpoints ◽  
Reminder Phone Call ◽  
Prior Notification

A no-show appointment is clinically defined as a scheduled appointment in which a patient fails to attend without prior notification to the provider or staff. In primary care clinics, no-show rates have been shown to range from 15% to 30%. Smaller studies have shown that interventions including phone calls, emails or text message reminders can reduce no-show rates.1–9 Our retrospective review sought to evaluate a similar intervention performed at the Multispecialty Residency Clinic (MSC). A test of two proportions was performed to evaluate the effect of a 24-hour reminder phone call. The no-show rate before initiating a 24-hour phone call was 17.8%, and following the intervention this rate improved to 16%, an observed reduction of 1.9% with a 95% confidence interval (CI) from 0.1% to 3%, p = 0.003. New patient encounters, established patient visits and cancellations were analyzed as secondary endpoints to further evaluate the effects of a reminder phone call. Our retrospective analysis is the largest to date regarding the effectiveness of utilizing phone call reminders to reduce no-show rates in the setting of a residency clinic and has confirmed a significant 2% reduction in no-show appointments.

scholarly journals An embedded randomised controlled trial of a Teaser Campaign to optimise recruitment in primary care

2017 ◽  
Vol 14 (2) ◽  
pp. 162-169 ◽  
Author(s):  
Hopin Lee ◽  
Markus Hübscher ◽  
G Lorimer Moseley ◽  
Steven J Kamper ◽  
Adrian C Traeger ◽  
...  
Keyword(s):  
Primary Care ◽  
Clinical Trial ◽  
Randomised Controlled Trial ◽  
Confidence Interval ◽  
Controlled Trial ◽  
Fundamental Principle ◽  
User Engagement ◽  
Primary Care Clinics ◽  
Invitation Letter ◽  
Randomised Controlled

Background: Marketing communication and brand identity is a fundamental principle of advertising and end-user engagement. Health researchers have begun to apply this principle to trial recruitment in primary care. The aim of this study was to evaluate whether a Teaser Campaign using a series of postcards in advance of a conventional mail-out increases the number of primary care clinics that engage with a clinical trial. Methods: Embedded randomised recruitment trial across primary care clinics (general practitioners and physiotherapists) in the Sydney metropolitan area. Clinics in the Teaser Campaign group received a series of branded promotional postcards in advance of a standard letter inviting them to participate in a clinical trial. Clinics in the Standard Mail group did not receive the postcards. Results: From a total of 744 clinics that were sent an invitation letter, 46 clinics in the Teaser Campaign group and 40 clinics in the Standard Mail group responded (11.6% total response rate). There was no between-group difference in the odds of responding to the invitation letter (odds ratio = 1.18, 95% confidence interval = 0.75–1.85, p = 0.49). For physiotherapy clinics and general practice clinics, the odds ratios were 1.43 (confidence interval = 0.82–2.48, p = 0.21) and 0.77 (confidence interval = 0.34–1.75, p  = 0.54), respectively. Conclusion: A Teaser Campaign using a series of branded promotional postcards did not improve clinic engagement for a randomised controlled trial in primary care.

Adherence to Colorectal Cancer Screening in Internal Medicine Resident Primary Care Clinics

2012 ◽  
Vol 107 ◽  
pp. S792-S793
Author(s):  
Kunut Kijsirichareanchai ◽  
Charoen Mankongpaisarnrung ◽  
Naree Panamonta ◽  
Grerk Sutamtewagul ◽  
Matt Soape ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Colorectal Cancer ◽  
Primary Care ◽  
Cancer Screening ◽  
Colorectal Cancer Screening ◽  
Internal Medicine Resident ◽  
Primary Care Clinics ◽  
Medicine Resident

scholarly journals 1066. Antimicrobial Stewardship Program: Audit and Feedback for Continued Improvement

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S377-S378
Author(s):  
Joseph Wang ◽  
Bryan Alexander ◽  
Scott Bergman ◽  
Jihyun Ma ◽  
Erica J Stohs ◽  
...  
Keyword(s):  
Antimicrobial Stewardship ◽  
Online Survey ◽  
Text Message ◽  
Audit And Feedback ◽  
Phone Call ◽  
Categorical Variables ◽  
Antibiotic Overuse ◽  
Phone Calls ◽  
Stewardship Program ◽  
Order Sets

Abstract Background Audit and feedback is a foundational approach used by antimicrobial stewardship programs (ASP) and has been our primary method for ASP intervention for over 7 years. We sought to evaluate and improve our ASP methods as well as identify barriers to effective antimicrobial management. Methods We distributed an online survey at our institution, to clinicians (prescribers and pharmacists). Results compared their perceptions of the ASP and barriers to antimicrobial stewardship. Descriptive statistics include counts and percentages for categorical variables. Fisher’s exact test was performed to describe the comparison groups for each survey response. We reviewed survey comments and categorized according to themes. Results We distributed the survey to 459 clinicians over 4 months with 110 surveys completed for a response rate of 24%. Prescribers comprised 77.3% of respondents. 74.5% of clinicians reported that antibiotic overuse is a problem at our institution. Prescribers were more likely to agree that conflicting priorities to core measures was a barrier to stewardship as well as disagree with current guidelines (P < 0.05) compared with pharmacists. Figure 1 demonstrates other barriers. Prescribers found ASP more helpful than pharmacists in antimicrobial dose adjustments (P < 0.05). Figure 2 demonstrates other scenarios where ASP provided input with varying degrees of perceived helpfulness. Pharmacists used the ASP website more than prescribers (P < 0.05). Text message and phone call were preferred methods of contact with prescribers favoring messages and pharmacists favoring phone calls. Clinicians infrequently used order-sets; Figure 3 demonstrates reasons for lack of use. 17.2% of participants commented about the ASP; of these, 42% were positive and 32% contained suggestions to improve communication and education. Comments are summarized in Figure 4. Conclusion Overall, clinicians agree that antimicrobial overuse is a concern at our institution. ASP is generally well received; however, after 7 years of operation, this survey shows that continued improvement is needed, notably in communication, education, and EMR order-sets. Results will be used to refine methods of effective communication and information delivery to nurture an effective relationship. Disclosures All authors: No reported disclosures.

scholarly journals Quality of Outpatient Care With Internal Medicine Residents vs Attending Physicians in Veterans Affairs Primary Care Clinics

2019 ◽  
Vol 179 (5) ◽  
pp. 711 ◽  
Author(s):  
Samuel T. Edwards ◽  
Hyunjee Kim ◽  
Sarah Shull ◽  
Elizabeth R. Hooker ◽  
Meike Niederhausen ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Primary Care ◽  
Outpatient Care ◽  
Veterans Affairs ◽  
Primary Care Clinics ◽  
Internal Medicine Residents ◽  
Attending Physicians

scholarly journals Readmission Rates Associated with Pharmacist Involvement in a Geriatric Transitional Care Management Clinic

2019 ◽  
Vol 10 (3) ◽  
pp. 20
Author(s):  
E. Jared McPhail ◽  
Vincent D. Marshall ◽  
Tami L. Remington ◽  
Sarah E. Vordenberg
Keyword(s):  
Primary Care ◽  
Care Management ◽  
Transitional Care ◽  
Phone Call ◽  
Readmission Rates ◽  
Phone Calls ◽  
Significant Difference ◽  
Nurse Navigator ◽  
The Impact ◽  
Three Components

Objective: To evaluate the impact of a post-discharge pharmacist telephone call on 30- and 90- day readmission reates as part of a transitional care management (TCM) service in a geriatiric patient-centered medical home (PCMH). Methods: Adults 60 years of age and older who had established primary care at the PCMH for at least one year and were discharged from the hospital between 7/1/2013 and 2/21/2016 were included.  Readmission rates for patients who received and did not receive a pharmacist TCM phone call were compared. Secondary data analysis was conducted between individuals who received all three components of the service compared with those who received on a nurse navigator plus primary care provider (PCP) visit. Results: Among 513 discharges of unique patients (mean age, 80.4 years; women 63%), 269 (52.4%) received a pharmacist phone call.  Readmission rates at 30 days were 8.9% for patients who received a pharmacist TCM phone call compared to 12.7% for those who did not receive this service (OR 0.67 [95% CI, 0.38-1.18; P=0.17]). When comparing only those individuals who received all three components of the service (pharmacist, nurse navigator, and PCP) (n=215) compared to those who received only a nurse navigator plus PCP visit (n=66), there was no difference in 30-day readmission rates (7.9% vs. 10.6%, p=0.49). However, there were significantly fewer readmissions within 90-days (16.3% vs. 31.8%, p=0.01). Conclusion: Pharmacist phone calls as part of an interdisciplinary TCM service did not result in a statistically significant difference regarding readmission rates at 30 days; however, patients who received all three components of the service had significantly fewer readmissions at 90 days, compared to patients who did not speak with a pharmacist but did complete a visit witha nurse navigator and physisian. Future research is needed to determine which patients may benefits the most from this service and to identify strategies to increase patient participation.   Article Type: Student Project      

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