How to manage antenatal visit schedules in a gynaecology clinic

Manage antenatal visits as one course for each pregnancy. Book the coming visits before the patient leaves, follow every scan and test from the order to the result, keep a weekly list of who has missed a visit, and agree the fee at the start. The clinical schedule is the doctor's. The clinic's job is to make sure nothing on it is lost.

This guide is about running the clinic. It does not say which visit, scan or test is due at which week. Follow the schedule you practise by.

Treat each pregnancy as one course of visits

Keep the antenatal visits of one pregnancy together, numbered, and apart from the patient's other visits. Then the file answers the two questions asked at every check-up: which visit is this, and was the last one attended. A diary that holds each visit as a separate, unrelated appointment cannot answer either without someone turning back the pages.

Book the next visits before she leaves

Book ahead at the desk, on the day of the visit, while the patient and her family are in front of you. Book as far ahead as your schedule is fixed. If the gap between visits changes later in the pregnancy, book the first part now and the next part when the doctor sets it. Keep the same weekday and time where you can, because the person who comes with her has to plan for it too.

Follow every scan and test to its result

A scan or test has four states, and the clinic should know which one each is in:

1. Ordered: the doctor has asked for it, and the date it is wanted by is written down.
2. Done: the patient has had it, at your clinic or outside.
3. Result back: the report is in the patient's file.
4. Seen: the doctor has read it and noted what follows.

The gap that causes trouble is between the first and the third: an order was written and no report ever came back. Check the open orders before each antenatal clinic day, and ask for the missing reports when you remind the patient of her visit.

Keep a weekly list of who has missed a visit

Once a week, list every antenatal patient whose visit date has passed without her coming, and call each one. Give the list to one named person at the desk. Record the outcome of each call in the file: rebooked, delivered elsewhere, moved away, or not reachable. A missed visit with no note beside it looks the same next week, and gets missed again.

Put the antenatal package in writing

If you charge one fee for the pregnancy, write down what it covers and give the patient a copy. State these points:

• Which visits are included, and whether extra visits are charged.
• Which scans and tests are included, and which are billed apart.
• Whether the delivery is part of the package or a separate bill.
• How the fee is paid: at once or in parts, and when each part is due.
• What is refunded if the patient moves to another doctor.

Record each part payment on the day it is made, so the desk can tell her what is still to pay without asking the doctor.

If your clinic does ultrasound

A clinic that does obstetric ultrasound in India has registration and record-keeping duties under the PCPNDT Act and its rules. They are separate from your clinical record, and the forms and the periods for keeping them are set by law. We do not summarise them here. Check the current rules with the authority that registered your clinic or with your legal adviser, and name one person in the clinic who is responsible for the paperwork every day.

Give pregnant patients their place in the line

Decide a rule for the waiting room and tell the desk. A woman late in pregnancy should not sit for an hour behind routine follow-ups. Mark her token at the desk so the doctor sees it in the line and decides the order.

How Curogrid does it

In Curogrid, a gynaecology clinic turns on “Book antenatal visits” while booking. The visits are booked together, 4 visits 4 weeks apart unless you change the number or the gap, and each is labelled, for example “Visit 2 of 4”. The patient's file opens on a Visits and care card that shows the antenatal visits booked and done. 5 scans and 10 tests are one-tap orders, and each order and its result sit under Tests and scans in the file. A token can be marked “Pregnant”. An “Antenatal package, full term” is a starter service at ₹12,000, a price you change to your own, and a bill can be paid in parts.

Curogrid does not work out the due date or the weeks of pregnancy for you. The gap it fills in is only a starting point, and the schedule is yours to set. A clinic that scans gets a PCPNDT registration task on its setup checklist, but Curogrid does not generate or file Form F. It is for the clinic and the OPD: admitted patients, beds and the discharge summary are not built yet. Curogrid costs ₹399 a month on Plus or ₹999 on Pro, for the whole clinic, with a 5-day free trial of Pro.