Document Type

Doctoral Project

Publication Date

2017

Abstract

Follow-up care by a primary care provider (PCP) immediately following a visit to the pediatric urgent care is recommended by the American Academy of Pediatrics. Unfortunately, studies indicate that between 26-56% of patients do not complete a recommended follow-up appointment with PCPs. Communication in the form of reminders to parents, guardians, and patients over the age of 18 may have the potential to increase rates of follow-up appointments after an urgent care visit. Short Message Service (SMS) text messages have been shown to be an effective means of communication between providers and patients in multiple types of healthcare settings. The purpose of this Evidenced-Based Practice (EBP) project was to improve patient attendance at follow-up PCP appointment after discharge from a pediatric urgent care for patients with diagnoses of wheezing, bronchospasm, and/or asthma exacerbation. Findings from the literature suggest attending follow-up appointments with the PCP can improve patient outcomes through quicker recovery, decreased need for subsequent visits to the urgent care and/or emergency department, and increased provider and parent/guardian/patient satisfaction. This project implemented the use of SMS text message reminders to parents, guardians, and patients over the age of 18, to make and complete follow-up appointments with their PCP after discharge from the urgent care.

The project was implemented with one group of patients in the pediatric urgent care; those with discharge diagnoses of wheezing, bronchospasm, and/or asthma exacerbation. Data collection included demographic data such as age, gender, race, ethnicity, PCP, and insurance type, SMS text message data such as message failure rates, and follow-up appointments attendance. Baseline data showed a follow-up rate of 53% for these patients during the fiscal year 2015-2016. Findings after the implementation of the SMS text messaging intervention showed a 57.8% follow-up rate for similar types of patients. The 4.8% increase in four-week follow-up visit rate during the pilot was not statistically significant. An argument could be made that these findings are clinically significant since a small improvement in follow-up visits were noted.

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