Endocrine Abstracts

Introduction: Managing a nurse-led Hyperthyroid Telephone Clinic with over 700 patients is challenging. If thyroid function blood test results are not available for review, telephone appointments are cancelled, resulting in empty clinic slots. A trial using direct messaging software in DrDoctor was initiated to improve clinic utilisation. This substituted best practice 14-day appointment reminder messages with two-way messaging between patients and nurses.

Method: All patients who had already consented to receive messages from DrDoctor were included in the trial. Blood test reminder messages were sent with the option for patients to reply with the date of a blood test or rearrange appointments.

Results: Before the trial, 109 patients were called over a 6-week period out of a possible 384 appointments. Comparatively, 274 patients were called out of a possible 384 appointments after direct messaging was implemented. Patient replies allowed nurses to rearrange appointments and fill empty clinic slots at short notice. The nurse prescriber was made aware of last-minute blood results to avoid cancellations. Patients were able to request alternative appointments, improving attendance during the clinic. Clinic preparation time reduced as template messages could be sent to multiple patients at once. Appointment availability improved with less overbooking required. Early feedback from a small sample of patients is positive overall.

Conclusion: Initial data suggests direct messaging can improve clinic utilisation and management of follow-up clinics, with wider implications for Endocrinology. Communication between patients and nurses improved and as a result clinic utilisation improved. More data is needed over a longer period of time to determine any variable factors not accounted for in the current trial period. Following this trial, the nursing team will pilot sending direct messages instead of making telephone calls for hyperthyroid follow up. If successful, this will have potential for monitoring appointments in other areas of Endocrinology.