Post-operative telephone review is cost-effective and acceptable to patients
R T Gray, M K Sut, S A Badger, C F Harvey, R T Gray, M K Sut, S A Badger, C F Harvey
Abstract
Introduction: Patients undergoing selective minor emergency and elective procedures are followed up by a nurse-led structured telephone review six weeks post-operatively in our hospital. Our study objectives were to review patients' satisfaction, assess cost-effectiveness and compare our practice with other surgical units in Northern Ireland (NI).
Patients and methods: Completed telephone follow-up forms were reviewed retrospectively for a three-year period and cost savings calculated. Fifty patients were contacted prospectively by telephone using a questionnaire to assess satisfaction of this follow-up. A postal questionnaire was sent to 68 general and vascular surgeons in NI, assessing individual preferences for patient follow-up.
Results: A total of 1378 patients received a telephone review from September 2005 to September 2008. One thousand one hundred and seventy-seven (85.4%) were successfully contacted, while 201 (14.6%) did not respond despite multiple attempts. One hundred and forty-seven respondents (10.7%) required further outpatient follow-up, thereby saving 1231 outpatient reviews, equivalent to £41,509 per annum. Thirty-nine (78%) patients expected post-operative follow-up, with 29 (58%) expecting this in the outpatient department. However, all patients were satisfied with the nurse-led telephone review. Fifty-three (78%) consultants responded. Those who always, or occasionally, review patients post-operatively varies according to the operation performed, ranging from 2.2% appendicectomy patients to 40.0% for varicose vein surgery.
Conclusion: Current practice in NI varies, but a significant proportion of patients are not routinely reviewed. This study confirmed that patients expect post-operative follow-up. A nurse-led telephone review service is acceptable to patients, cost-effective and reduces the number of unnecessary outpatient reviews.
Keywords: Telephone review; post-operative; telephone follow-up.
References
- Car J, Sheikh A. Telephone consultations. Br Med J. 2003;326:966–969.
- Moran SJ, Jarvis S, Ewings P, Parkin FA. It's good to talk, but is it effective? A comparative study of telephone support following day surgery. Clinical Effectiveness in Nursing. 1998;2:175–184.
- McVay MR, Kelley KR, Mathews DL, Jackson RJ, Kokoska ER, Smith SD. Postoperative follow-up: is a phone call enough? J Ped Surg. 2008;43:83–86.
- Jones J, Clarke W, Bradford J, Dougherty J. Efficiency of a telephone follow-up system in the emergency department. J Emerg Med. 1988;6:249–254.
- Fallis WM, Scurrah D. Outpatient laparoscopic cholecystectomy: home visits versus telephone follow-up. Can J Surg. 2001;44:39–44.
- Brough RJ, Pidd H, O'Flynn KJ, Payne SR. Identification of patients requiring out-patient follow-up after transurethral prostatectomy: is there a role for nurse-led screening of post-operative outcomes by telephone? Br J Urol. 1996;78:401–404.
- Rosbe KW, Jones D, Jalisis S, Bray MA. Efficacy of post-operative follow-up telephone calls for patients who underwent adenotonsillectomy. Arch Otolaryngol Head Neck Surg. 2000;126:718–721.
- Wedderburn AW, Dodds SR, Morris GE. A survey of post-operative care after day case surgery. Ann R Coll Surg Eng. 1996;78(2 Suppl):70–71.
Source: PubMed