After-Hours Calls in a Joint Replacement Practice.

Area of Science:

• Orthopedic Surgery
• Patient Care Management
• Health Services Research

Background:

• Early discharge after joint arthroplasty necessitates robust patient management resources.
• Addressing patient concerns outside of business hours is crucial to prevent emergency department visits and readmissions.
• A system to manage post-discharge patient needs is vital for successful early discharge protocols.

Purpose of the Study:

• To evaluate the utilization of an after-hours telephone system in a high-volume early discharge joint replacement practice.
• To assess the effectiveness of direct surgical team access for patients post-discharge.

Main Methods:

• A Google phone number was used to provide patients access to the surgical team after hours and on weekends.
• Prospective data collection over 3 months (July-October 2017) included call duration, chief complaint, and resolution.
• Analysis focused on call patterns and patient outcomes in relation to the after-hours contact system.

Main Results:

• Sixty-eight calls were received from 55 patients over a 3-month period, with 325 joint replacement surgeries performed.
• Average call duration was 3.9 minutes, with calls occurring an average of 17.5 days post-surgery.
• Suboptimal health literacy was linked to increased calls within the first week (OR=4.1), and pain was a common complaint in revision surgeries (OR=3.23).

Conclusions:

• An after-hours telephone contact service involving surgical team members can reduce unnecessary emergency department visits.
• Approximately one call per day was managed, with brief average durations, indicating efficient resource utilization.
• These supplementary resources are essential for ensuring patient safety and satisfaction in early discharge joint replacement programs.