Background

Adherence to postoperative follow-up improves weight loss and reduces or prevents vitamin/mineral deficiencies and other adverse events. Patient compliance to postoperative follow-up, however, tends to regress over time. To improve follow-up, we 1)determined the effect of a new scheduling process workflow on long-term (two-year) adherence and completion of labs, and 2) identified contributory factors to scheduling nonadherence.

Methods

The study population included 176 out of 268 MBS patients who missed their two-year follow-up visit in 2023. An electronic medical record (EMR) appointment task feature created an appointment notification for the receptionist. An educational tool was used to train the receptionist about the workflow guide and appointment task. Data was collected using Microsoft Excel and analyzed using descriptive statistics.

Results

Using the workflow guide, 159 (90%) of the 176 originally unscheduled patients were called. Of these, 75 or 47% scheduled an appointment and 53% did not. This resulted in a 45% increase in follow-up adherence, from a rate of 34% to 62%. All (100%) of scheduled patients had labs ordered. Sixty-one (81%) of patients scheduled a telemedicine visit and 19% preferred an in-office visit. Patients who did not schedule had a reason documented in their EMR. Scheduling nonadherence was unrelated to either patient demographics (ethnicity, gender, age, BMI) or surgical procedure (Roux-en-Y gastric bypass, duodenal switch, sleeve gastrectomy).

Conclusions

The implementation of the workflow guide had a positive impact on the scheduling of long-term follow-ups and labs ordered.