Factors Associated with Patient-Initiated Telephone Calls After Spine Surgery.

Factors Associated with Patient-Initiated Telephone Calls After Spine Surgery.

World Neurosurg. 2016 Nov 9;:

Authors: Reid R, Puvanesarajah V, Kandil A, Yildirim B, Shimer AL, Singla A, Shen FH, Hassanzadeh H

Abstract
BACKGROUND: Telephone calls play a significant role in the follow-up care of postoperative patients. However, further data is needed to identify the determinants of patient-initiated telephone calls following surgery as these factors may also highlight potential areas of improvement in patient satisfaction and during the hospital discharge process. Thus, the goal of this study is to determine the number of postoperative patient telephone calls within 14 days following surgery and establish the factors associated with patient-initiated calls as well as reasons for calling.
METHODS: A retrospective chart review of all spine surgeries performed at our institution from January 1, 2014 through January 2, 2015 was completed. Patient demographics, perioperative and operative variables, and telephone encounter data were collected. The primary outcome was a patient-initiated telephone call within 14 days after surgery. Secondary outcomes included reporting and analyzing the reasons for patient phone calls, analyzing which procedures were associated with the most telephone calls, and conducting a multivariate analysis to determine independent risk factors for patient calls.
RESULTS: Of the 488 patients who underwent surgical procedures, 222 patients (45.7%) made a telephone call within 14 days after surgery. 61 patients (27.48%) called regarding pain control. 54 patients (23.87%) called with bathing/dressing/wound questions. Other common categories include: other (21.17%), medication problems (15.77%), weight bearing status/activity restrictions (5.14%), fever (3.15%), bowel management (1.35%), work notes (1.35%), and anticoagulation questions (0.45%). Factors associated with a telephone call within 14 days postoperatively included increased BMI (p=0.031), lower number of comorbidities (p=0.043), telephone call within two weeks prior to surgery (p=0.027), American Society of Anesthesiology (ASA) score of 2 (p=0.036), discharge disposition to home (p=0.003), and elective procedure (p=0.006). Multivariate analysis revealed that fusion procedures (OR: 2.16, 95% CI: 1.05 - 4.45, p = 0.037) and ASA score of 3-4 (OR: 0.55, 95% CI: 0.31 - 0.96, p = 0.036) were independently associated with increased and decreased propensity, respectively, towards making a phone call within two weeks.
CONCLUSIONS: Postoperative patient-initiated telephone calls within 14 days following spine surgery are very common, occurring after almost half of all procedures. By evaluating such determinants, patient care can be improved by better addressing patient needs during and prior to discharge to prevent potential unnecessary postoperative calls and improve patient satisfaction.

PMID: 27838431 [PubMed - as supplied by publisher]

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