173 Effect of Direct Physician-Patient Communication on Postpartum Follow Up

To increase the rate of postpartum clinic visits at the 3 week postpartum interval by contacting patients at the 2 week postpartum mark. In this prospective cohort study, our intervention consisted of physicians directly contacting patients from November 2019 to January 2020 through phone calls at the 2 week postpartum mark in order to assess their postpartum challenges and encourage them to attend the upcoming 3 week visit. A voicemail was left if call not answered. Data from November 2018 through January 2019 was used as control for comparison. Our primary outcome was rate of 3 week postpartum clinic visit . With 25% effect size, and 80% power, we estimated that a sample size of 466 subjects would be required to achieve our goal. Chi square test analysis was used. P<0.05 was considered statistically significant. 1,261 patients were identified as controls. A total of 475 phone calls were placed during the intervention period. 263 patient were directly spoken to and 212 patients were left voicemails. Women that received either (direct communication or voicemail), were more likely to attend their 3 week postpartum visit compared to control (82.5% vs 77.4%; Relative risk (RR): 1.06, 95%CI [1.01-1.12]; (P=0.02). There was no significant differences in the 6 week postpartum appointments among groups (61.3% vs 58.2%; RR: 1.05, 95%CI [0.96-1.14]; P=0.25). Subjects that received direct communication were more likely to attend both their 3 week (84.0% vs 77.4%; RR: 1.08, 95%CI [1.02-1.15]; P=0.017) and 6 week clinic appointments (65.4% vs 58.21%; RR: 1.12, 95%CI [1.01-1.24]; P=0.031). Physician phone calls to patients has a significant impact on increasing postpartum visit rates. While leaving voicemails for patients significantly increases 3 week postpartum visits, having a direct phone conversation with the patient significantly increases both the 3 and 6 week postpartum visit rates. A healthcare provider phone call placed at 2 weeks postpartum can help improve the postpartum visit rate and make a positive impact on women's health in the vulnerable postpartum period.