Patient-reported symptom tracking and intervention in real time after pancreatic surgery: A quality improvement...

Pancreatic surgeries carry high post-discharge complication and readmission rates, often due to delayed recognition of symptoms. This study evaluates feasibility of an application-based patient-reported symptoms system following hospital discharge to track recovery after major oncologic surgery.

A QI initiative was launched in an academic setting for pancreatic surgery patients, recruiting patients to participate in a real-time symptom monitoring program via a smartphone application. Daily surveys for 2 weeks following discharge assessed 10 symptoms potentially signaling complications. Recovery trajectory was tracked, with algorithmically triggered alerts to Virtual Health Center (VHC) using pre-specified thresholds. Alerts prompted tiered response from VHC technician to nurse or physician, who contacted the patient for symptom verification, intervention, or escalation to the surgical team. After program completion, patients evaluated satisfaction with the application/survey and VHC, using a 0-10 scale, 10 indicating maximum satisfaction.

Between August 2023 and February 2024, 21 patients were enrolled to the program at pre-operative visit. Thirteen patients have successfully completed the program, 5 await surgery/discharge, 3 did not participate after discharge. Whipple procedure was most common-8 (61.5%). Median days for patients to enroll after discharge was 1 (0.5-1.5 IQR) and median number of days in program was 14 (13.5-14.5 IQR). On average, patients responded to 81.5% of surveys (11.9 out of 14.6). Alerts to VHC were triggered 138 times, requiring escalation to VHC physician 11 times. Median post-program patient satisfaction was 10/10 (IQR, 7.5-10) with the application/survey and 10/10 (IQR, 10-10) with the VHC.

The study suggests the feasibility of an application-based system for real-time monitoring of patient-reported symptoms after pancreatic surgery, demonstrating promising early levels of patient compliance and satisfaction.