Managing patient follow up can be challenging for a number of reasons. Patient noncompliance, heavy workloads, multiple care providers, and a lack of systems or tools to facilitate timely follow up are hurdles to overcome. But initiating and maintaining strong follow up and communication policies and procedures can help enhance patient care and outcomes.
 
While patient tracking systems will vary from practice to practice, there are four basic steps physicians can follow to help ensure test results and consult reports are managed properly.

• Track tests until results are received.
• Notify patients of the results.
• Document that the notification occurred.
• Ensure that patients with abnormal results receive recommended follow-up care.

Preventing errors related to patient follow up‍

Consider the following guidelines to help reduce liability related to failure to follow up.
 

• Have a well-defined and consistently followed process to verify that test results have been received and acted upon. Processes should be developed for both diagnostic studies and specialist referrals, with clear responsibilities outlined.
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• Consider using the tracking systems built into your electronic health record to set reminders and alerts, and to flag any follow-up needs. Recognize that these systems are only effective when they are used consistently.
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• Develop procedures to prioritize abnormal or unexpected findings. Document the assessment, recommended treatment plan, and verify that follow-up care has been arranged.
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• For physicians who are copied on outside diagnostic reports, follow a formal process for handling these reports, regardless of who ordered them. This includes notifying the patient, confirming that follow up is underway, or contacting the ordering physician to clarify next steps.
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• Establish procedures for patients who do not complete their follow-up care. This includes missed appointments, incomplete testing, or referrals that were never completed. 

A proven approach is scheduling follow-up appointments before patients leave the office, accompanied by clear written instructions about timing and purpose. Automated appointment reminders via text, email, or phone reduce no-shows, while priority scheduling ensures urgent follow up can be accommodated quickly.
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• Engage patients in their own care to strengthen follow-up systems. Explaining why a test has been ordered allows the patient to recognize its importance.
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• Avoid using the “no news is good news” approach for communicating test results. Directly communicate all test results and follow established procedures for critical or abnormal findings.
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• When seeing a patient for follow up after a hospital discharge, ask staff to request the hospital discharge summaries and review any orders and/or recommendations before the patient’s follow-up visit. Direct staff members to obtain copies of pertinent hospital records and labs, tests, and/or radiology reports for the office chart.
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• When discharging patients, follow clear protocols for tracking pending test results and critical findings that emerge post-discharge. Contact the patient and outpatient physicians with results when necessary. Identify any radiology study discrepancies between initial and final reads, and act quickly to notify physicians or patients when needed.
  
  Ensure patients know who to follow up with after leaving the hospital. When possible, ask for assistance from hospital staff in setting up appointments with outpatient providers. Provide clear, written instructions with specific dates, time frames, and criteria for seeking immediate medical attention. Verify understanding by having patients verbalize the follow-up plan before discharge.
  
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