Related Experiment Videos
Outpatient outcomes and satisfaction in pediatric population: data from the postoperative phone call
B Randall Brenn1, Dinesh K Choudhry1, Karen Sacks1
1Department of Anesthesiology, Nemours/Alfred I. duPont Hospital for Children, Wilmington, DE, USA.
Insights
Postoperative phone surveys are effective for assessing pediatric outpatient complications and satisfaction. Patient satisfaction was not linked to complication rates, suggesting operational improvements are key.
Area of Science:
- Pediatric Perioperative Medicine
- Healthcare Quality Improvement
- Patient Safety
Background:
- Pediatric perioperative services aim to optimize quality and patient satisfaction.
- A postoperative phone call questionnaire was developed alongside an operating room electronic medical record (EMR) implementation.
- The initiative sought to identify common postoperative complications and reasons for patient/parent dissatisfaction.
Purpose of the Study:
- To assess the rate of common postoperative complications in pediatric outpatients.
- To understand the primary drivers of patient/parent dissatisfaction.
- To evaluate the utility of a postoperative phone survey in a pediatric setting.
Main Methods:
- A postoperative phone survey was administered by postanesthesia care unit nursing staff to pediatric outpatients.
- Data from over 37,000 phone records (2009-2013) were extracted from the EMR (Epic Optime) into a business intelligence program (QlikView).
- A business intelligence dashboard was used to calculate complication rates (nausea, vomiting, pain, bleeding, hoarseness, difficulty eating) and dissatisfaction rates.
Main Results:
- A high response rate of 88% (37,620 completed calls out of 42,688 cases) was achieved.
- Pain was the most frequently reported complication at 11.1%.
- The overall dissatisfaction rate was low at 0.31%, with most dissatisfied patients not reporting complications; satisfaction showed little relationship with complication presence.
Conclusions:
- Postoperative phone surveys are a cost-effective method appreciated by patients for evaluating perioperative services.
- Patient/parent satisfaction with pediatric perioperative services was found to be largely independent of reported complication rates.
- Improvements in operational factors, such as wait times, may be more impactful for enhancing patient satisfaction than solely focusing on complication reduction.
Background:
Quality and patient/parent satisfaction are goals for pediatric perioperative services. As part of the implementation of our operating room electronic medical record (EMR), a postoperative phone call questionnaire was developed to assess patients discharged after outpatient surgery. The goal of this initiative was to determine the rate of common postoperative complications and understand reasons for patient/parent dissatisfaction.
Methods:
Institutional Review Board approval was obtained for chart review. The postoperative phone call survey was attempted by our postanesthesia care unit nursing staff on all pediatric outpatients. The call was attempted for 3 days. From 2009 to 2013, more than 37 000 phone records existed in our EMR, Epic Optime (Epic Systems, Verona, WI). These data were extracted to a business intelligence (BI) program, QlikView (Qliktech, Radnor, PA, USA). A BI dashboard was constructed to obtain phone call results for any given time frame from monthly to spanning several years. Complications were logged as 4-point severity rating scales (none, mild, moderate, severe) with descriptions for each level. The BI dashboard calculated the overall and rates by severity for the following: (i) nausea, (ii) vomiting, (iii) pain, (iv) bleeding, (v) hoarseness, and (vi) difficulty eating.
Results:
Of 42 688 outpatient cases, 37 620 postoperative phone calls were completed for an overall response rate of 88%. Pain, at 11.1%, was the highest reported postoperative complication. The rate of dissatisfaction was reported to be 0.31%. Most patients reporting dissatisfaction (62%) did not report any complications. Contingency coefficient showed that there was little relationship between satisfaction and presence of complications.
Conclusion:
A postoperative phone survey is cost-effective and appreciated by patients. We found that satisfaction with our perioperative services was not related to the rates of reported complications. Although reducing complications is of utmost importance, improvements in wait times and other operational issues would yield greater improvements in satisfaction.
Related Concept Videos
01:26Types of Reports III: Telephone and Verbal Reports
Here's an overview of each type:
Telephone Orders
01:26Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
01:16Kidney Transplant III: Nursing Management
01:29Appendicitis-II: Diagnostic Studies and Management
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
01:29Suctioning the Nasopharyngeal Airway
Equipment Required
01:23Peripheral Artery Disease V: Postoperative Nursing Management