Creation And Evaluation Of A Nursing Initiated Post-Operative Phone Call System To Decrease Healthcare Utilization After Ureteroscopy
Kevan Sternberg, MD1, Alia Johnson, BA2, Juvena Hitt, MPH2.
1University of Massachusetts, Worcester, MA, USA, 2University of Vermont, Burlington, VT, USA.
Background:Ureteroscopy is common and increasing with post-procedure symptoms that are well established and difficult to avoid. Patient concerns lead to calls to clinic and ED visits requiring valuable resources. We hypothesize that calling patients after surgery to address concerns will decrease healthcare utilization Methods:QI team including urologist, clinic nurses, data collector, analyst executed a project based on the Plan Do Study Act (PDSA) framework. All patients undergoing ureteroscopy called on POD 1-3 with a standardized EHR phone call template. Demographics, comorbidities, calls to clinic, ED visits, and reasons for the calls and ED visits were documented. Results:A total of 95 cases recorded where 31 received call and 64 did not receive call. There were no differences in age, comorbidities, or prior opioid use in regard to patient calls to clinic or visits to ED. Of 31 pts called, 11 called the office (34%) and of 64 pts not called, 21 called the office (33%). The main reason for call included pain (17), urinary symptoms (10), medication questions (10). A single patient who called went to the ED (3%) while 5 (8%) who were not called presented to the ED where the main reason for ED visit was pain. Conclusions: A standardized post-operative phone call system after ureteroscopy was able to be created and implemented which found the main patient concern to be pain. Calls may decrease ED visits after ureteroscopy but, further study is needed. The need for future patient education regarding post-operative medications provided was identified. Another significant barrier is limited nursing availability. Input from nursing and patients regarding satisfaction are future steps for this initiative.
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