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Outpatient laparoscopic cholecystectomy: home visit versus telephone follow-up
1Faculty of Nursing, University of Manitoba, Department of Research and Evaluation, Victoria General Hospital, Winnipeg.
Objectives:
To investigate the post-discharge follow-up required for patients who have undergone laparoscopic cholecystectomy on an outpatient basis and to determine if there was a significant difference in mean concern scores and satisfaction level of patients followed up by a home visit versus a telephone call.
Design:
Prospective 2-group comparison.
Setting:
A 221-bed acute care community hospital in western Canada.
Patients:
One hundred and forty-nine patients who had undergone laparoscopic cholecystectomy and agreed to be discharged on the day of operation.
Interventions:
Subjects were systematically allocated to receive either a home visit (HV, n = 72) or a telephone call (TC, n = 77) from a registered nurse on the evening of operation. During the follow-up, patient concerns were self-rated, interventions provided by the nurse were recorded, and nurses' perceptions of the need for the home visit were reported. A 48-hour telephone survey was used to determine patient satisfaction.
Outcome Measures:
Patient concern scores, patient satisfaction with follow-up, readmission rates and use of emergency room services within 30 days of operation.
Results:
Subjects in the TC group had a significantly lower mean concern score (p < 0.001) and were significantly more satisfied with their follow-up (p = 0.034) than those in the HV group. Nurses perceived that 75% of the home visits were not necessary. Readmission rate was less than 1% (1 HV) and use of emergency room services was 6% (3 HV, 6 TC).
Conclusions:
Telephone contact is an acceptable method of follow-up for patients who have undergone outpatient laparoscopic cholecystectomy. The call should be made later in the evening on the day of operation or the next morning.