Efficacy and utility of phone call follow-up after pediatric general surgery versus traditional clinic follow-up

Abstract

Context: Typical follow-up for surgical procedures consists of an interim history and brief focused physical examination. These appointments occupy clinic resources, require a time investment by the family, and rarely identify problems. Previous studies have demonstrated the safety of a postoperative phone call.

Objective: Compare a traditional in-person clinic postoperative visit with postoperative phone call follow-up regarding patient satisfaction, rate of successful follow-up, and clinic resource utilization in a large academic practice.

Design: A retrospective review of charts of patients who underwent select surgical procedures, along with a review of the clinic schedule for the same time period.

Main outcome measures: Efficacy, patient/family satisfaction, and impact on the clinic.

Methods: Families were contacted by telephone two weeks after select surgical procedures to assess for complications and questions. Cohorts of patients six months before and six months after implementation were assessed for main outcome measures.

Results: Before implementation, 55.5% of patients (427/769) who had one of the select surgical procedures were seen in the clinic postoperatively, and 62.6% (435/695) had a successful postoperative phone call follow-up. There were also 1090 overall scheduled postoperative appointments. Six months after implementation, overall postoperative appointments decreased 35.5% to 703. Overall, postoperative-scheduled visits decreased by 6% compared with new visits and other general follow-up visits, which each increased by 3%. A satisfaction survey revealed that 93% of patients (n = 231) were highly satisfied with the process. A hospital cost analysis suggested an 89% cost savings ($101.75 per patient for clinic visit vs $12.50 per patient for phone call follow-up).

Conclusion: Postoperative phone call follow-up is an effective tool that improves patient and physician efficiency and satisfaction.

Figures

Figure 1.

Phone follow-up protocol. EMR = electronic medical record.

Figure 2.

Schedule clinic appointment by type.