Improvement in Outpatient Follow-up With a Postdischarge Phone Call Intervention

Abstract

Introduction: Attending clinic appointments after injury is crucial for orthopaedic trauma patients to evaluate healing and to update recommendations. However, attendance at these appointments is inconsistent. The purpose of this study was to assess the effect of a personalized phone call placed 3 to 5 days after hospital discharge on attendance at the first postdischarge outpatient clinic visit. Methods: This prospective study was done at an urban level 1 trauma center. One hundred fifty-nine patients were exposed to a reminder phone call, with 33% of patients being reached for a conversation and 28% receiving a voicemail reminder. Phone calls were made by a trained trauma recovery coach, and the main outcome measure was attendance at the first postdischarge clinic visit. Results: Eighty-six patients (54%) attended their scheduled appointments. Appointment adherence was more common among the group reached for a conversation (70% versus 51% for voicemail cohort and 34% for no contact group). Patients exposed to the Trauma Recovery Services (TRS) during their hospital stay attended appointments more often (91% versus 61%, P = 0.026). Age, sex, mechanism of injury, and distance from the hospital were not associated with specific follow-up appointment adherence. Insured status was associated with higher attendance rates (71% versus 46%, P = 0.0036). Other economic factors such as employment were also indicative of attendance (64% versus 48%, P = 0.05). Current tobacco use was associated with poor appointment attendance (30%) versus 56% for nonsmokers (P = 0.001). Discussion: Patients reached by telephone after discharge had better rates of subsequent clinic attendance. Economic factors and substance use appear vital to postoperative clinic visit compliance. Patients with met psychosocial needs, as identified by individuals with satisfactory emotional support, and exposure to TRS had the highest rates of postdischarge appointment attendance.

Telemedicine trends in orthopaedics and trauma during the COVID-19 pandemic: A bibliometric analysis and review

“…Fifty-nine articles met the inclusion criteria and were considered for the analysis. 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 The excluded thirty-four papers were editorials, letters, duplicate entries, and articles with no discussion on telemedicine even in the full text ( Figure 1 ). The monthly contributions trend of the orthopaedic telemedicine-related articles is shown in Figure 2 .…”

“… 44 , 52 , 55 Hendrickson et al. 56 observed better follow-up compliance among patients receiving post-discharge telemedicine-based care. The issues witnessed with orthopaedic telemedicine included limited physical examination and the need for a detailed in-person evaluation of patients with multiple comorbidities, advanced age, or obesity.…”

Nonadherence to follow-up recommendations is common for dogs and cats undergoing orthopedic surgery

“…The most common elective procedure was tibial plateau leveling osteotomy (n = 167), and the most common urgent procedure was long bone fracture repair (142). Other elective procedures included medial patellar luxation correction (n = 39), femoral head and neck ostectomy (27), total hip arthroplasty (20), corrective osteotomy for angular limb deformity (13), shoulder arthroscopy (11), tarsal arthrodesis (10), lateral suture stabilization (10), elbow arthroscopy (7), carpal arthrodesis (6), and center of rotation and angulation-based leveling osteotomy (4). Other urgent procedures included mandibular fracture repair (n = 16) and pelvic fracture repair (13).…”

“…Clinician communication styles and institutional programs can also influence adherence to recommendations, including recommendations for follow-up examination. 7,8…”

Trauma System Support to Facilitate Recovery

“…40,41 Over several years, the TRS evolved to include printed and online health education resources, coaching, counseling, peer mentorship, support groups, resources for crime victims, and PTSD screening and intervention. 39,[42][43][44][45][46] Recent specific interventions by the TRS team have included developing an app for injury education and recovery advice and a novel inpatient teach/teach back brief educational intervention, to improve recall. This work has generated better health literacy, more adherence to treatment recommendations, and better patient satisfaction.…”