Presenter Status

Fellow

Abstract Type

QI

Primary Mentor

Claire Hickey

Start Date

4-5-2022 11:30 AM

End Date

4-5-2022 1:30 PM

Presentation Type

Poster Presentation

Description

Problem Statement/Question: Children in the foster care system experience barriers to continuity of care, both in the primary and subspecialty outpatient settings.

Background/Project Intent (Aim Statement): To decrease average percentage of scheduled but missed specialty appointments whose initial referrals were placed in the Foundations Foster Care Clinic (FCC) from 40% to 20% over a 10- month period from March-December 2020.

Methods (include PDSA cycles): Referrals to specialty clinics were placed during an initial or follow-up visit in the Foundations Foster Care Clinic (FCC). One PDSA cycle was performed and involved notification of the patient’s case worker when a referral was placed, and review of the patient’s chart within 30 days of FCC visit to confirm scheduling of specialty appointment(s). If appointments were cancelled, missed, or not scheduled, the case worker was contacted to determine patient’s current placement status. If in a new placement, the patient’s contact information was updated, and the new placement was notified of need to schedule specialty appointments. If in the same placement, the placement was notified of need to schedule specialty appointments. The patient was then followed via chart review for up to 3 months to ensure attendance of appointments. Data was reported based on outcome of appointment 3 months following the initial date of specialty referral. Data was compared between March-December 2018 (pre-PDSA cycle) and March-December 2020 (PDSA cycle) using descriptive statistics.

Results: There were 149 referrals placed pre-PDSA cycle compared to 153 referrals during PDSA cycle. The average percentage of scheduled but missed appointments decreased from 15% pre-PDSA to 13% during PDSA cycle. The monthly percentage of scheduled but missed appointments during PDSA cycle remained under 20% except for November and December 2020. The average percentage of appointments scheduled and attended increased from 57% pre-PDSA cycle to 67% during PDSA cycle. The average percentage of appointments never scheduled decreased from 28% pre-PDSA cycle to 25% during PDSA cycle.

Conclusions: There was a modest decrease in the average percentage of scheduled but missed appointments between pre-PDSA and during PDSA cycle. However, both pre- and during PDSA cycles average percentages were still well within goal. Frequent and centralized coordination of care is warranted to improve continuity of care of children in the foster care system.

Share

COinS
 
May 4th, 11:30 AM May 4th, 1:30 PM

Initiating Coordination of Care for Children in State Custody or Shelter Care

Problem Statement/Question: Children in the foster care system experience barriers to continuity of care, both in the primary and subspecialty outpatient settings.

Background/Project Intent (Aim Statement): To decrease average percentage of scheduled but missed specialty appointments whose initial referrals were placed in the Foundations Foster Care Clinic (FCC) from 40% to 20% over a 10- month period from March-December 2020.

Methods (include PDSA cycles): Referrals to specialty clinics were placed during an initial or follow-up visit in the Foundations Foster Care Clinic (FCC). One PDSA cycle was performed and involved notification of the patient’s case worker when a referral was placed, and review of the patient’s chart within 30 days of FCC visit to confirm scheduling of specialty appointment(s). If appointments were cancelled, missed, or not scheduled, the case worker was contacted to determine patient’s current placement status. If in a new placement, the patient’s contact information was updated, and the new placement was notified of need to schedule specialty appointments. If in the same placement, the placement was notified of need to schedule specialty appointments. The patient was then followed via chart review for up to 3 months to ensure attendance of appointments. Data was reported based on outcome of appointment 3 months following the initial date of specialty referral. Data was compared between March-December 2018 (pre-PDSA cycle) and March-December 2020 (PDSA cycle) using descriptive statistics.

Results: There were 149 referrals placed pre-PDSA cycle compared to 153 referrals during PDSA cycle. The average percentage of scheduled but missed appointments decreased from 15% pre-PDSA to 13% during PDSA cycle. The monthly percentage of scheduled but missed appointments during PDSA cycle remained under 20% except for November and December 2020. The average percentage of appointments scheduled and attended increased from 57% pre-PDSA cycle to 67% during PDSA cycle. The average percentage of appointments never scheduled decreased from 28% pre-PDSA cycle to 25% during PDSA cycle.

Conclusions: There was a modest decrease in the average percentage of scheduled but missed appointments between pre-PDSA and during PDSA cycle. However, both pre- and during PDSA cycles average percentages were still well within goal. Frequent and centralized coordination of care is warranted to improve continuity of care of children in the foster care system.

 

To view the content in your browser, please download Adobe Reader or, alternately,
you may Download the file to your hard drive.

NOTE: The latest versions of Adobe Reader do not support viewing PDF files within Firefox on Mac OS and if you are using a modern (Intel) Mac, there is no official plugin for viewing PDF files within the browser window.