Using Follow Up Cards to Improve Workflow in an Outpatient Residency Clinic

Ensuring adequate and timely follow-up is one of the essential parts of providing good patient care in a primary care setting. If the next visit is not scheduled prior to a patient leaving the clinic, it often results in them being “lost to follow-up.” This results in inadequate care, delays in treatment, and increased burden of disease. Using the currently available scheduling mechanism in our EHR is a tedious and time-consuming process that makes it difficult to arrange for follow up visits prior to the patient arriving at the checkout window after they leave the exam room. This often resulted in no appointment being scheduled at all or one much later than the provider intended. Our proposed solution to this problem was to replace the electronic scheduling mechanism with small paper “follow-up cards” that patients are given to take to the checkout desk with them. We implemented this new process in our clinic for a 3-month period and evaluated resident satisfaction with follow-up and checkout procedures before and after the change. We found that residents preferred using the card system because they felt it improved their workflow in clinic and improved efficiency of scheduling follow up visits. Given the positive reviews, it was decided to implement the follow up cards as a permanent mechanism for scheduling appointments in our clinic until a more efficient electronic system can be arranged.