Triage in Maternal Fetal Medicine: Reducing Appointment Reschedules

Staff of maternal fetal medicine (MFM) identified inefficiencies in the scheduling processes causing unnecessary rework and inhibiting patient care. Many patient interventions and follow-up tests are dependent upon gestational parameters, making the timing of appointment critically important. Reschedules create rework and can decrease patient satisfaction. Creating efficiencies within today's staffing challenges is key to aid in both patient and staff satisfaction overall. A new process was identified and implemented with the goal to decrease appointment reschedules by 25%. Using the PDSA model for improvement, three interventions were selected and evaluated, while remaining FTE neutral. Those three interventions included creation of an appointment triage process, development of an MFM levels of care document and formation of a nurse triage calendar to promote closed loop communication with our multidisciplinary team. Post-intervention measures identified a 42% improvement. This project had a significant impact on patient satisfaction through improved access while simultaneously improving Nursing, Medical Administrative Assistant, and Patient Appointment Services Specialist team satisfaction through efficiencies gained.