Follow-up Attendance Among USF BRIDGE Physical Therapy Patients

Objectives: Establish baseline attendance data to inform quality improvement for patient follow-up care at BRIDGE Physical Therapy Clinic. Background: The BRIDGE Healthcare Clinic is a student-run free clinic affiliated with the University of South Florida, serving the surrounding University Area community. Based on informal observation, there is potential for improving patient attendance. Quantitative assessment of baseline data regarding current attendance for initial visits, follow-up visits, and length of episodes of care were obtained via retrospective review of electronic health record (EHR). Methods and Measures: HIPAA/CITI certified BRIDGE Physical Therapy Patient Coordinators abstracted data from patient records maintained in Practice Fusion, the EHR system utilized by BRIDGE Clinic, between October 2012 and September 2013 (N = 67). Patients seen for more than one initial evaluation within the designated time period (i.e. more than one episode of care) were excluded from the sample. Data regarding attendance for initial visit, follow-up visits, and length of episode of care were abstracted, deidentified, and reported in an Excel document. Frequency counts and percentages were derived using IBM SPSS Statistics, version 21. Likelihood of follow-up attendance based on attendance for initial visit was calculated using logistic regression. Associations between duration of care and overall attendance were examined using bivariate correlation. Results: There was a low rate of attendance for both initial physical therapy visits (60%), and follow-up visits (43%). Conclusion: Low rate of attendance indicates the need for quality improvement efforts targeting causative factors to improve initial and follow-up visit attendance. Suspected reasons for non-attendance include inconsistency of care, lack of transportation, and patient satisfaction. Findings from this study will inform further investigation towards subsequent changes in policy and procedures. Recommendations include implementation of a standardized classification system for patient chief complaints, efforts to ensure that follow-up visits are appropriately scheduled after initial visit, and maintenance of clinic operation throughout the entire year, opposed to the academic calendar.