Reducing readmissions and improving patient experience following urological surgery, through early telephone follow-up

Abstract

Readmission from urological surgery is common, with a readmission rate for day case surgery of 3.7% and 26% for robot-assisted cystectomy. Readmission to secondary care and representation to primary care are both expensive and preventable. This project aimed to reduce both and also enhance the care of patients following urological surgery in a large tertiary referral centre, within the National Health Service. A retrospective telephone follow-up (TFU) survey was set up in the early postoperatively period to measure reattendance and readmission rates and perception of care received. Patients were also asked to suggest how improvement could be made. Quality improvement tools were used to optimise and review the methods and timing of TFU. TFU was initiated as a strategy to enhance care and reduce readmission rates. Phone calls were targeted to occur between 48 and 72 hours following discharge. During the intervention period, 484 phone calls were attempted with 343 being successful. Reattendance rates were reduced by 13% and patient satisfaction improved by 19.6%, following TFU. This intervention also generated additional income for the organisation and enhanced patient satisfaction in the early postoperative period.

Streamlining brain tumor surgery care during the COVID-19 pandemic: A case-control study

“…Although our brain tumor center treats mostly non-emergent patients (94%) with a high proportion of patients with prior surgery (25%), our pathology mix is similar to that of other centers and trends with national brain tumor demographics [25]. Additionally, while our findings are specific to patients with primary and secondary brain tumors, many of these measures are relevant and applicable to other specialties and are already being implemented in some centers [44,47,48,53,54].…”

“…However, the protocol we implemented early in the pandemic allowed us to still bring patients to surgery and rapidly and safely discharge them. We postulate, as others have shown, that more extensive patient education and expectation management of their ability to safely leave the hospital helped in this effort [47,48]. Patient motivation in minimizing their hospital stay has helped facilitate these changes, which would have previously been met with a level of reluctance.…”

Text Messaging, Telephone, or In-Person Outpatient Visit to the Surgical Clinic: A Randomized Trial

“… 8 , 10 Telephone calls to patients as a follow-up has been shown to be associated with reduced readmission rates of up to 80% among discharged patients after surgery. 7 A previous study at our institution established that patients preferred telephone follow-up clinics to in-person outpatient visits. 15 There is evidence, however, that text messages are preferred over other forms of communication because of their simplicity.…”

“…Telehealth is less expensive for health-care providers, and for recipients, and improves health-care access 4 , 5 while reducing avoidable readmissions, emergency department visits, and overtime reimbursements. 6 , 7 The benefits of telemedicine have been observed across a range of different specialities 8 , 9 , 10 , 11 , 12 , 13 , 14 and for surgical outpatient services. 9 , 15 , 16 , 17 Patients also associate telehealth follow-up, especially text messaging, with increased information retention.…”

Nurse-led telephone follow-up according to the revised nursing outcomes classification for laryngeal carcinoma surgery patients: a randomized controlled trial

“…Nurse-led telephone follow-up is the most frequently used approach for providing follow-up care that includes individual health guidance and psychological support. Telephone follow-up has already been introduced for patients in various settings, including follow-up after urological surgery, cataract surgery, Mohs micrographic surgery, pelvic floor surgery, and for patients experiencing obstructive sleep apnea [ 9 – 13 ]. Research has shown that health care quality and the burden of postoperative symptoms or patient satisfaction could improve if patients receive telephone follow-up [ 9 – 13 ].…”