Abstract Title: Enhancing Continuity of Care in Outpatient Setting: A Quality Improvement Initiative

Background: Continuity of care is the process of ensuring high-quality care over time through a continuous, long-term relationship between patients and physicians. When patients receive consistent care from the same healthcare provider, it enhances the provider’s understanding of the patient’s medical history and preferences, leading to better communication, enhanced trust, thus fostering strong doctor-patient relationships. This continuity was documented to reduce healthcare costs, improve medication adherence and patient satisfaction. Residency programs in internal medicine are required to create a continuous relationship between residents and a panel of patients. However, maintaining continuity can be challenging due to limited time and availability of residents, as well as scheduling issues.

Methods: We aimed to improve continuity of care by at least 50% at Federally Qualified Health Center (FQHC) of our hospital during the period of September to December 2023. Interventions include: 1. Educating residents on the importance of continuity of care through presentations and posters. 2. Preparing the annual resident schedule in advance to facilitate appropriate follow-up scheduling. 3. Confirming patient availability to ensure clinic visits on agreed dates. 4. Coordinating with support staff involved in setting up appointments by providing them access to the annual resident schedule.

Results: During the specified period, a total of 313 patients were seen in the clinic who met the inclusion criteria, with 184 (58.8%) of them being females. The mean age of the group was 48.9 (14.8) years. Out of 151 patients in the pre-intervention group, 13.9% (21) were followed by the same physician during their visits. This figure increased to 26.5% (43 among the 162 patients) in the post-intervention group. This disparity was statistically significant, with a p-value of 0.006. There were no notable differences in gender or age between the two groups (p-value > 0.05). Resident survey: All the residents (100%) emphasized the extreme importance of continuity of care. 68% of the residents have observed patients requesting to be seen by the same physician during their clinic visits. When asked how they would perceive patient satisfaction levels post-intervention, 75% of them found that patients were more satisfied.

Conclusion: Our project resulted in increasing in the continuity of care from 13.9% to 26.5%, which was statistically significant. A physician-led, team-based approach to healthcare along with targeted interventions can facilitate continuity of care, reducing fragmentation of care and improving patient health care quality and patients’ satisfaction.