The Flexible Care Pathway: An Alternative Paradigm for Post-Operative Care.

Area of Science:

• Orthopedic Surgery
• Patient Care Pathways
• Health Services Research

Background:

• Telehealth has shown benefits in reducing costs and increasing patient satisfaction post-operatively.
• A Flexible Care Pathway (FCP) involving "as-needed" follow-up has not been formally evaluated.
• This study investigates the safety and satisfaction of FCP for carpal (CTR) and cubital tunnel release (CuTR).

Purpose of the Study:

• To evaluate the safety and patient satisfaction of a Flexible Care Pathway (FCP) compared to Conventional Follow-up (CFU).
• To assess outcomes including FCP to CFU conversions, complications, patient travel time and distance, and satisfaction levels.

Main Methods:

• Veterans undergoing carpal or cubital tunnel release were offered a choice between FCP ("as-needed" follow-up) and CFU (in-person visit within 2 weeks).
• Both groups received detailed post-operative instructions.
• Patients were contacted 30 days post-operatively via phone for a satisfaction questionnaire.

Main Results:

• 60.2% of 105 enrolled patients chose the FCP.
• Only 23.7% of FCP patients required an in-person visit.
• FCP patients reported higher satisfaction (9.5/10) than CFU patients (8.6/10) and traveled significantly less (p < 0.05).

Conclusions:

• The FCP is a safe and highly satisfactory option for ambulatory hand surgery follow-up up to 30 days post-operatively.
• FCP significantly reduces patient travel time and distance compared to CFU.
• This pathway is particularly beneficial for patients in remote areas, those with limited access to specialty care, and during pandemics.