Establishing a postoperative clinic via the telephone helped significantly improve utilization of surgeon and facility resources while maintaining patient outcomes at a Veterans Affairs facility, according to a study published by the Journal of the American College of Surgeons.
For the study, researchers gave patients undergoing low-risk abdominal, neck and skin or soft tissue operations the option of speaking with a surgeon via telephone instead of visiting a clinic in person for their follow-up appointment. Patients who chose the telephone clinic option were scheduled for follow-up call about two weeks after their procedures. Those patients who could not be reached for their telephone call were scheduled for in-person care. Around 200 patients underwent eligible operations, 29 before the telephone clinic was established and 171 after.
Here are six insights:
1. Utilization of the in-person clinic decreased from 0.83 visits per eligible patient before the telephone clinic was created to 0.4 visits after the telephone clinic's implementation. .
2. There was little difference in procedure-related readmissions and emergency department visits among eligible patients when rates before and after the implementation of the telephone clinic were compared — 0.17 and 0.12 respectively.
3. Among patients who completed telephone consultations, 89 percent were discharged and 11 percent were escalated to a repeat phone call or a clinic visit.
4. Two or three surgical providers spent an extra hour per week conducting the telephone clinic, with each consultation lasting between five minutes and 30 minutes per patient.
5. The in-person clinic took about 15 to 60 minutes of provider time.
6. The time gained from the telephone clinic was used to see additional patients.
"We are pleased with the results of this intervention, which has increased access to care while mitigating long travel distances and inconvenience for many of our patients," said Kristy Kummerow Broman, MD, MPH, lead study author and a general surgery resident at Vanderbilt University in Nashville, Tenn.