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Goehner D, Kandregula S, Birk H, Carroll CP, Guthikonda B, Kosty JA. Improving patient care in neurosurgery through postoperative telephone calls: a systematic review and lessons from all surgical specialties. Neurosurg Focus 2021; 51:E5. [PMID: 34724638 DOI: 10.3171/2021.8.focus21410] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 08/25/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Postoperative telephone calls are a simple intervention that can be used to improve communication with patients, potentially affecting patient safety and satisfaction. Few studies in the neurosurgical literature have examined the effect of a postoperative telephone call on patient outcomes, although several exist across all surgical specialties. The authors performed a systematic review and analyzed studies published since 2000 to assess the effect of a postoperative telephone call or text message on patient safety and satisfaction across all surgical specialties. METHODS A search of PubMed-indexed articles was performed on June 12, 2021, and was narrowed by the inclusion criteria of studies from surgical specialties with > 50 adult patients published after 1999, in which a postoperative telephone call was made and its effects on safety and satisfaction were assessed. Exclusion criteria included dental, medical, and pediatric specialties; systematic reviews; meta-analyses; and non-English-language articles. Dual review was utilized. RESULTS Overall, 24 articles met inclusion criteria. The majority reported an increase in patient satisfaction scores after a postoperative telephone call was implemented, and half of the studies demonstrated an improvement in safety or outcomes. CONCLUSIONS Taken together, these studies demonstrate that implementation of a postoperative telephone call in a neurosurgical practice is a feasible way to enhance patient care. The major limitations of this study were the heterogeneous group of studies and the limited neurosurgery-specific studies.
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Affiliation(s)
- Dylan Goehner
- 1University of Massachusetts Medical School, Department of General Surgery, Worcester, Massachusetts
| | - Sandeep Kandregula
- 2Louisiana State University Health Shreveport School of Medicine, Department of Neurosurgery, Shreveport, Louisiana
| | - Harjus Birk
- 2Louisiana State University Health Shreveport School of Medicine, Department of Neurosurgery, Shreveport, Louisiana
| | - Christopher P Carroll
- 3Department of Brain & Spine Surgery, Naval Medical Center, Portsmouth, Virginia; and.,4Department of Surgery, Division of Neurosurgery, Uniformed Services University, Bethesda, Maryland
| | - Bharat Guthikonda
- 2Louisiana State University Health Shreveport School of Medicine, Department of Neurosurgery, Shreveport, Louisiana
| | - Jennifer A Kosty
- 2Louisiana State University Health Shreveport School of Medicine, Department of Neurosurgery, Shreveport, Louisiana
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Dang KLT, Badge H, Harris IA. Validity of patient-reported complications after total hip and knee arthroplasty. J Orthop Surg (Hong Kong) 2019; 26:2309499018802493. [PMID: 30270744 DOI: 10.1177/2309499018802493] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Evaluating the effectiveness of total hip arthroplasty (THA) and total knee arthroplasty (TKA) often relies on accurate patient reporting of postoperative complications. Despite this, there is little research regarding the accuracy of patient reports. We aimed to determine the accuracy of patient-reported significant complications after THA and TKA. METHODS Patients were recruited prior to undergoing primary hip or knee arthroplasty at 19 high-volume hospitals. After surgery, follow-up of patients via telephone interviews at 35, 90 and 365 days recorded surgical outcomes including readmission, reoperation and venous thromboembolism (VTE). Patient-reported complications were verified via medical record audits and liaison with surgeons, general practitioners or other health professionals. Surgical and demographic information and patient-reported and verified complications were entered into a database. Patient-reported and verified complications were compared for readmission, reoperation and VTE. RESULTS The sample included 150 of 1811 patients who reported a total of 242 significant complications. Of the 242 patient-reported complications, 224 (92.6%) were correct (true positive). The type of complication had variable levels of accuracy in patient reports. Readmission to hospital was accurately reported by 90.2% (129/143) of patients. Reoperation (including any manipulations under anaesthesia, joint washouts, reductions of dislocated joints and revisions) was accurately reported by 98.7% (75/76) of patients. VTE was accurately reported by 86.7% (20/23) of patients. CONCLUSION A high level of accuracy in patient-reported experience of complications was demonstrated following THA and TKA. Patient-reported complications may be reliably used for post-operative surveillance of joint replacement surgery.
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Affiliation(s)
- Kinh Luan Thanh Dang
- 1 Whitlam Orthopaedic Research Centre, Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, UNSW Sydney, Liverpool, New South Wales, Australia
| | - Helen Badge
- 1 Whitlam Orthopaedic Research Centre, Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, UNSW Sydney, Liverpool, New South Wales, Australia.,2 NSW Agency for Clinical Innovation, Chatswood, New South Wales, Australia
| | - Ian A Harris
- 1 Whitlam Orthopaedic Research Centre, Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, UNSW Sydney, Liverpool, New South Wales, Australia
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Saglam-Aydinatay B, Taner T. Oral appliance therapy in obstructive sleep apnea: Long-term adherence and patients experiences. Med Oral Patol Oral Cir Bucal 2018; 23:e72-e77. [PMID: 29274155 PMCID: PMC5822544 DOI: 10.4317/medoral.22158] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Accepted: 10/10/2017] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Despite the advances in the treatment of obstructive sleep apnea (OSA) with mandibular advancement appliances (MAA), their effectiveness is dependent on the patients compliance. Our aims were to evaluate the long-term adherence to MAA therapy and patients experiences of the treatment in OSA. MATERIAL AND METHODS Sixty-nine patients (52 males, 17 females; Mean age: 54.4±10.8 years) were included in the study. The subjects were mild (56%) and moderate (44%) OSA patients who had been treated using MAA at least 4 years prior to the study. A phone survey was used to determine the demographic characteristics of the patients, as well as to assess self-reported adherence to therapy, subjective long-term effectiveness, and patient experiences with the appliance. Descriptive statistics, Pearson Chi-square test, and independent samples t-test were used for data analysis. RESULTS Only 22 (32%) patients reported using the appliance regularly. Most of the non-adherent patients had stopped using their appliances in the first year (55%). The mean duration of appliance use was 33.5 months (Median: 12 months). No significant differences in appliance type, OSA severity, educational level, gender, marital status, income status, employment status or place of residence existed between adherent and non-adherent subjects. Adherent subjects were significantly younger than non-adherent subjects (Age: 50.6 ± 11.9 versus 56.1 ± 9.9, p < 0.05). The most common reasons reported by patients were inability to adapt to the appliance (62%) and pain in the temporomandibular joint (38%). The most common factors associated with continued usage were effectiveness (100%) and ease of use (64%). CONCLUSIONS The overall long-term nonadherence to MAA therapy in mild-to moderate OSA patients was high suggesting that barriers to MAA therapy adherence should be prevented to increase the efficiency of oral appliance treatment in OSA and achieve better outcomes for this disease.
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Affiliation(s)
- B Saglam-Aydinatay
- Department of Orthodontics, Faculty of Dentistry, Hacettepe University, Sihhiye, Ankara 06100, Turkey,
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Methodologic Considerations for Collecting Patient-reported Outcomes from Unselected Surgical Patients. Anesthesiology 2016; 125:495-504. [DOI: 10.1097/aln.0000000000001217] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Abstract
Background
The impact of surgery on health is only appreciated long after hospital discharge. Furthermore, patients’ perceptions of postoperative health are not routinely ascertained. The authors instituted the Systematic Assessment and Targeted Improvement of Services Following Yearlong Surgical Outcomes Surveys (SATISFY-SOS) registry to evaluate patients’ postoperative health based on patient-reported outcomes (PROs).
Methods
This article describes the methods of establishing the SATISFY-SOS registry from an unselected surgical population, combining perioperative PROs with information from electronic medical records. Patients enrolled during their preoperative visit were surveyed at enrollment, 30 days, and 1-yr postoperatively. Information on PROs, including quality of life, return to work, pain, functional status, medical complications, and cognition, was obtained from online, mail, or telephone surveys.
Results
Using structured query language, 44,081 patients were identified in the electronic medical records as having visited the Center for Preoperative Assessment and Planning for preoperative assessment between July 16, 2012, and June 15, 2014, and 20,719 patients (47%) consented to participate in SATISFY-SOS. Baseline characteristics and health status were similar between enrolled and not enrolled patients. The response rate for the 30-day survey was 62% (8% e-mail, 73% mail, and 19% telephone) and for the 1-yr survey was 71% (13% e-mail, 78% mail, and 8% telephone).
Conclusions
SATISFY-SOS demonstrates the feasibility of establishing a PRO registry reflective of a busy preoperative assessment center population, without disrupting clinical workflow. Our experience suggests that patient engagement, including informed consent and multiple survey modalities, enhances PROs collection from a large cohort of unselected surgical patients. Initiatives like SATISFY-SOS could promote quality improvement, enable efficient perioperative research, and facilitate outcomes that matter to surgical patients.
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Schwarze C, Zenz D, Orlowski O, Wempe C, Van Aken H, Zahn P, Maier C, Pogatzki-Zahn EM. [Survey of pain after ambulatory surgery: An internet-based instrument]. Schmerz 2015; 30:141-51. [PMID: 26541856 DOI: 10.1007/s00482-015-0071-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND AIM Pain after surgery continues to be undermanaged. Studies and initiatives aiming to improve the management of postoperative pain are growing; however, most studies focus on inpatients and pain on the first day after surgery. The management of postoperative pain after ambulatory surgery and for several days thereafter is not yet a major focus. One reason is the low return rate of the questionnaires in the ambulatory sector. This article reports the development and feasibility of a web-based electronic data collection system to examine pain and pain-related outcome on predefined postoperative days after ambulatory surgery. MATERIAL AND METHODS In this prospective pilot study 127 patients scheduled for ambulatory surgery were asked to participate in a survey to evaluate aspects related to pain after ambulatory surgery. The data survey was divided in (1) a preoperative, intraoperative and postoperative part and (2) a postoperative internet-based electronic questionnaire which was sent via e-mail link to the patient on days 1, 3 and 7 after surgery. A software was developed using a PHP-based platform to send e-mails and retrieve the data after web-based entries via a local browser. Feasibility, internet-based hitches and compliance were assessed by an additional telephone call after day 7. RESULTS A total of 100 patients (50 female) between 18 and 71 years (mean 39.1 ± 12.7 years) were included in the pilot study. Return rates of the electronic questionnaires were 86% (days 3 and 7) and 91% (day 1 after surgery). All 3 electronic questionnaires were answered by 82% of patients. Aspects influencing the return rate of questionnaires were work status but not age, gender, education level and preoperative pain. Telephone interviews were performed with 81 patients and revealed high operability of the internet-based survey without any major problems. CONCLUSION The user-friendly feasibility and operability of this internet-based electronic data survey system explain the high compliance and return rate of electronic questionnaires by patients at home after ambulatory surgery. This survey tool therefore provides unique opportunities to evaluate and improve postoperative pain management after ambulatory surgery.
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Affiliation(s)
- C Schwarze
- Klinik für Anästhesiologie, operative Intensivmedizin und Schmerztherapie, Albert-Schweitzer-Campus 1, Gebäude A1, 48149, Münster, Deutschland
| | | | - O Orlowski
- Klinik für Anästhesiologie, operative Intensivmedizin und Schmerztherapie, Albert-Schweitzer-Campus 1, Gebäude A1, 48149, Münster, Deutschland
| | - C Wempe
- Klinik für Anästhesiologie, operative Intensivmedizin und Schmerztherapie, Albert-Schweitzer-Campus 1, Gebäude A1, 48149, Münster, Deutschland
| | - H Van Aken
- Klinik für Anästhesiologie, operative Intensivmedizin und Schmerztherapie, Albert-Schweitzer-Campus 1, Gebäude A1, 48149, Münster, Deutschland
| | - P Zahn
- Abteilung für Schmerzmedizin, Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil, Bochum, Deutschland
| | - C Maier
- Abteilung für Schmerzmedizin, Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil, Bochum, Deutschland
| | - E M Pogatzki-Zahn
- Klinik für Anästhesiologie, operative Intensivmedizin und Schmerztherapie, Albert-Schweitzer-Campus 1, Gebäude A1, 48149, Münster, Deutschland.
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Visser A, Ubbink DT, Gouma DJ, Goslings JC. Surgeons Are Overlooking Post-Discharge Complications: A Prospective Cohort Study. World J Surg 2013; 38:1019-25. [DOI: 10.1007/s00268-013-2376-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Mirhosseini SM, Fakhri M, Mozaffary A, Lotfaliany M, Behzadnia N, Ansari Aval Z, Ghiasi SMS, Boloursaz MR, Masjedi MR. Risk factors affecting the survival rate in patients with symptomatic pericardial effusion undergoing surgical intervention. Interact Cardiovasc Thorac Surg 2012; 16:495-500. [PMID: 23250960 DOI: 10.1093/icvts/ivs491] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVES The optimal management and treatment of pericardial effusion are still controversial. There is limited data related to the risk factors affecting survival in these patients. The aim of this study was to determine the risk factors affecting the survival rate of patients with symptomatic pericardial effusion who underwent surgical interventions. METHODS From 2004 to 2011, we retrospectively analysed 153 patients who underwent subxiphoid pericardial window as their surgical intervention to drain pericardial effusions at the National Research Institute of Tuberculosis and Lung diseases (NRITLD). To determine the effects of risk factors on survival rate, demographic data, clinical records, echocardiographic data, computed tomographic and cytopathological findings and also operative information of patients were recorded. Patients were followed annually until the last clinical follow-up (August 2011). To determine the prognostic factors affecting survival, both univariate analysis and multivariate Cox proportional hazards model were utilized. RESULTS There were 89 men and 64 women with a mean age of 50.3 ± 15.5 years. The most prevalent symptom was dyspnoea. Concurrent malignancies were present in 66 patients. Lungs were the most prevalent primary site for malignancy. The median duration of follow-up was 15 (range 1-85 months). Six-month, 1-year and 18-month survival rates were 85.6, 61.4 and 36.6%, respectively. In a multivariate analysis, positive history of lung cancer (hazard ratio [HR] 2.894, 95% confidence interval [CI] 1.362-6.147, P = 0.006) or other organ cancers (HR 2.315, 95% CI 1.009-50311, P = 0.048), presence of a mass in the computed tomography (HR 1.985, 95% CI 1.100-3.581, P = 0.023), and echocardiographic findings compatible with tamponade (HR 1.745, 95% CI 1.048-2.90 P = 0.032) were the three independent predictors of postoperative death. CONCLUSIONS In the surgical management of pericardial effusion, patients with underlying malignant disease, especially with lung cancer, patients with a detectable invasion of thorax in computed tomography and those with positive echocardiographic findings compatible with tamponade have a poor survival. Therefore, minimally invasive therapies could be considered as a more acceptable alternative for these high-risk patients.
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Affiliation(s)
- Seyed Mohsen Mirhosseini
- Chronic Respiratory Disease Research Center, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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