Abstract Details

Title Quality Improvement Project: Factors for Stroke Clinic ‘No Shows’

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P3 - Poster Session 3 (12:00 PM-1:00 PM)

Poster/Presentation
Number 4-011

Objective To improve stroke outpatient follow-up (OPFU) compliance rate, we instituted a performance improvement project (PIP) to determine factors that contribute to OPFU non-compliance and to determine the effect of offering rescheduling.

Background Controlling modifiable risk factors provides a strong impact in secondary stroke prevention. Stroke OPFU provides a significant role in assuring these goals are met; however, not all patients are able to adhere to this. University of Mississippi Medical Center (UMMC) stroke clinic visit ‘no-show’ rate for 2018 is 27.5%, far from UMMC’s allowable rate of 10%.

Design/Methods Prospective data collection with retrospective chart review was done. For each patient labeled as “no-show” in clinic, the nurse scheduler called using provided script and data collection sheet asking for the reason for non-compliance. Included in the phone call was an inquiry if the patient wanted to reschedule. If they did, they were redirected to schedulers. Other demographic and clinical data were collected retrospectively. Descriptive statistics were done utilizing proportions, means, mode as appropriate.

Results Of the 53 OPFU non-compliant patients from 224 scheduled, 30 participated in the phone interview. Non-compliant patients were mostly females (64%), single (48%), African Americans (70%), uninsured (30%), and had MRS of 0 (26%). The most common reason for non-compliance was transportation (27%). Of those who answered, 27 (90%) patients rescheduled and 15 (56%) showed up for the rescheduled visit, which increased the overall compliance rate for this cohort of patients by 6.7%.

Conclusions

This PIP, with the intervention of calling patients to inquire about reasons for OPFU non-compliance with a follow-up question on rescheduling, facilitated understanding on modifiable system-wide processes and factors affecting stroke OPFU non-compliance. This also determined that a simple, no-cost intervention of asking about desire to reschedule can improve OPFU rate. Our ambulatory neurology department adapted this process to other neurology subspecialties.

Authors/Disclosures
Carmela San Luis, MD (Guthrie Hospital) PRESENTER	No disclosure on file
Shreyas Gangadhara, MD, FAAN (University of Mississippi Medical Center)	Dr. Gangadhara has nothing to disclose.
Shashank Shekhar, MBBS	The institution of Dr. Shekhar has received research support from Sponsor Department of Health and Human Services. The institution of Dr. Shekhar has received research support from PockitDx.
Christa O'hana S. Nobleza, MD	Dr. Nobleza has nothing to disclose.

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