Type of publication:
Journal article
Author(s):
*Younis, Zubair; Hamid, Muhammad A; *Khan, Muhammad Murtaza; Sapra, Rahul; *Gurukiran, Gurukiran; *Singh, Rohit.
Citation:
Cureus. 16(11):e73461, 2024 Nov.
Abstract:
Background Outpatient clinics are increasingly challenged by high patient volumes and rising "did not attend" (DNA) rates, leading to extended wait times and declines in patient satisfaction. Traditional follow-up (FU) models with routinely scheduled appointments contribute to inefficiencies, as stable patients may attend unnecessary visits, thus straining clinic resources. The patient-initiated follow-up (PIFU) model offers an alternative where patients schedule appointments only when necessary. This study evaluates PIFU's efficacy in improving outpatient services and patient satisfaction by reducing routine appointments and prioritizing patient-driven follow-up. Methods This service evaluation and patient satisfaction audit was conducted at the fracture clinic of Royal Shrewsbury Hospital over three months (December 2023-March 2024). Out of 3828 patients seen, 203 were assigned to PIFU based on criteria indicating stable conditions with minimal follow-up requirements. The remaining patients were either scheduled for routine follow-ups or discharged. Data were collected retrospectively from clinic records, and a structured
questionnaire assessed patient satisfaction with the PIFU service. Results Among the 203 patients assigned to PIFU, 183 (90.15%) patients received an informational leaflet, with all respondents finding it easy to understand. However, only 41 (20.2%) of patients utilized the PIFU service, primarily for concerns about pain, healing, or complications. Satisfaction among PIFU users was high, with 163 (80.3%) patients rating the service 5/5. Non-users mostly cited no perceived need for follow-up. Demographic analysis indicated that patients aged 40-60 were predominant (n=132; 65.02%) among the PIFU cohort. Conclusion The PIFU model demonstrated the potential to alleviate clinic workload by reducing routine follow-ups while maintaining high patient satisfaction. Although utilization rates were low, those who engaged found the service beneficial, suggesting PIFU's value for patients comfortable with self-management. Improved patient education may enhance engagement, supporting the broader implementation of PIFU in outpatient settings. Further research is warranted to explore barriers to patient-initiated follow-up and refine eligibility criteria for optimal outcomes.
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