If You Build It, Will They Come? A Mixed-Method Formative Evaluation of the Start-up of a Post-Discharge Clinic to Improve Care Transitions

Author:

Lee Seung-Yup1,Eagleson Reid1,Hearld Larry1,Gibson Madeline1,Hearld Kristine1,Hall Allyson1,Burkholder Greer1,McMahon Jacob1,Mahmood Shoaib1,Spraberry Corey1,Baker Thalia1,Garretson Alison1,Bradley Heather2,Mugavero Michael1

Affiliation:

1. University of Alabama at Birmingham

2. Cooper Green Mercy Hospital

Abstract

Abstract

Background The transition from hospital care to post-discharge follow-up is pivotal for patient health and healthcare system efficiency. While Post Discharge Clinics (PDCs) are designed to facilitate this transition, these new ventures can face challenges, such as patient adherence to appointments. Formative evaluations can provide guidelines for their effective implementation.Methods A mixed-method formative evaluation was conducted at the University of Alabama at Birmingham Health System (UABHS)'s PDC to evaluate the first 12 months of operation. The study combined quantitative analysis of patient characteristics, appointment status, and comorbidities with qualitative interviews of PDC staff to assess operational performance and identify areas for improvement.Results The quantitative analysis reported results on 2,168 PDC appointments during the study period. About half of the referred patients attended their appointment (52.1%), while the rest either cancelled (24.0%) or did not show up (23.3%). Statistically significant associations were found between patient demographic, socioeconomic, and clinical factors (e.g., marital status, insurance type, comorbidities) and adherence to appointments. The qualitative findings with PDC staff highlighted perceived benefits of the clinic, challenges in patient engagement, and the need for dedicated resources, such as social workers and specialists to optimize potential benefits.Conclusions The initial operation of the UAB PDC indicates the potential effectiveness of such clinics in improving transitional care. However, addressing barriers to patient adherence, particularly for socially vulnerable groups, and enhancing resource allocation based on stakeholder engagement are critical for the success and scalability of PDCs.

Publisher

Research Square Platform LLC

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