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Institution-initiated text messaging can reduce unplanned emergency department visits after appendectomy
Roshan J D'Cruz1, Lisa-Qiao MacDonald2, Natalina Zisa3
1Dept. of Pediatric General Surgery, Nemours Alfred I. duPont Hospital for Children, 1600 Rockland Rd, Wilmington, DE, USA 19803.
Insights
A new text messaging system significantly reduced unplanned Emergency Department (ED) visits for children after appendectomy. This proactive communication strategy improved patient care and resource utilization.
Area of Science:
- Pediatric Surgery
- Health Informatics
- Telemedicine
Background:
- Unplanned Emergency Department (ED) visits for minor complaints after pediatric appendectomy pose a challenge.
- Effective post-discharge communication is crucial for managing minor surgical complications and reducing healthcare costs.
Purpose of the Study:
- To decrease unplanned ED visits in children following appendectomy.
- To implement a proactive, institution-driven communication system utilizing telehealth resources.
Main Methods:
- A text messaging system was developed to engage parents of post-appendectomy patients.
- The system facilitated telehealth visits or direct communication with surgical providers.
- Retrospective analysis compared ED visit rates pre- and post-implementation using statistical process control.
Main Results:
- The postoperative ED visit rate decreased from 5.8% to 2.4% (p=0.02) after system implementation.
- 21.6% of families utilized the messaging system for postoperative questions.
- Over 90% of respondents found the system helpful, with a preference for video visits (52.5%).
Conclusions:
- A hospital-initiated text messaging system effectively reduces ED visits post-appendectomy in children.
- This scalable telehealth solution can be adapted for various surgical procedures and disciplines.
Background/Purpose:
The purpose of this study was to reduce unplanned Emergency Department (ED) visits for minor complaints in children after appendectomy through proactive institution-driven communication and utilization of telehealth resources.
Methods:
We developed a text messaging system to initiate communication with parents of postappendectomy patients and connect them with a telehealth visit or a phone call with a surgical provider as needed. Using descriptive statistics, chi square, and statistical process control analytics, we compared rates of postoperative ED visits for the 8 months pre- and post-implementation of the messaging system and summarized the feedback we received from patients.
Results:
A total of 791 laparoscopic appendectomies were performed in two institutions (preintervention = 382, post-intervention = 409). The postoperative ED visit rate decreased from 5.8% preimplementation to 2.4% post-implementation (p = 0.02). Over one-fifth of families messaged (21.6%) had questions in the postoperative period. The majority expressed interest in a video visit (52.5%), while some preferred to speak with the surgeon's office (25%). Over 90% of respondents found the system helpful, and 4.9% opted out.
Conclusion:
Implementation of a hospital-initiated text messaging system has the potential to reduce ED visits in the immediate postoperative period after appendectomy. This system can be scaled to include different surgeries across multiple disciplines.
Level Of Evidence:
III.
Type Of Study:
Clinical Retrospective Pre/Post Intervention Study.
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