N. A. Schreiter1, A. Fisher1, J. Barrett1, A. Acher1, L. Sell1, D. Edwards1, G. Leverson1, A. Joachim1, S. Weber1, D. Abbott1 1University Of Wisconsin,Department Of Surgery,Madison, WI, USA
Introduction: Surgical transitional care programs may decrease post-operative readmission rates and cost while also providing other indirect benefits, such as increased one-on-one attention with the patient and improved patient satisfaction scores. We hypothesized that a telemedicine-based surgical transitional care program would improve patient confidence in self-management, health education, and overall hospital experience.
Methods: A telemedicine-based surgical transitional care program enrolled patients that underwent abdominal oncologic or colorectal surgery between October 2015 to December 2017. A matched cohort undergoing similar procedures in the 5 years prior was used as the control group. Press-Ganey scores, a validated method of assessing patient satisfaction, were obtained from administrative databases. For responses on a Likert scale, a Wilcoxon rank sum was used to compare the groups’ responses, while binary yes/no responses were compared using Fisher’s exact test.
Results: 607 patients were enrolled in the pre-transitional care (control) cohort while 608 engaged in the program’s post-discharge phone calls. Satisfaction survey response rates were 37% and 35%, respectively. Surveys were completed, on average, two weeks following hospital discharge. Patients enrolled in the transitional care program believed they received better discharge instructions compared to controls, which included understanding their responsibilities in post-discharge care and whom to contact with questions (p=0.02 and p=0.04, respectively). Patients enrolled in the transitional care program felt they received better educational materials about their condition/treatment than the control group (p<0.01) and rated their global hospital experience higher than the control group (p=0.02). There was, however, no difference between the groups regarding their feeling of readiness for discharge (p=0.12).
Conclusion: Utilization of a telemedicine-based surgical transitional care program is associated with improved Press-Ganey scores related to patient education. Emphasis on patient education may lead to better adherence to post-discharge instructions and a concomitant improvement in clinical outcomes, thus supporting more widespread adoption of similar surgical transitional care programs.
