24: Post-operative patient-initiated telephone calls in an academic female pelvic medicine and reconstructive surgery practice: A retrospective study

Abstract

The purpose of this study was to evaluate reasons for patient calls in the post-operative period. Secondarily we evaluated: (i) factors associated with the number of phone calls in the post-operative period (ii) demographic differences between callers versus non-callers. After IRB approval, a retrospective chart review using electronic medical records was performed on consecutive patients who underwent surgery within our academic FPMRS practice from January 1, 2017 to June 30, 2017, inclusive. Calls following post-operative discharge until their first scheduled post-operative visit were included. Reasons and number of calls were tabulated. Demographic information including clinical and surgical factors was extracted. Continuous data (e.g., number of phone calls) were evaluated with a Student’s t test or ANOVA; categorical data were evaluated with a chi square test. Results yielding p < 0.05 were deemed statistically significant. Three hundred two patients underwent surgery during the designated period of time. One hundred seventy-three (57.3%) patients made a total of 345 calls with mean of 2.0 ± 1.5 calls each. There was no difference in age or BMI between callers and non-callers. A greater number of telephone calls in the post-operative period was recorded among patients discharged home with catheters (p = 0.015) and patients who underwent posterior colporrhaphy (p = 0.005), TVT (p = 0.004), and retropubic urethropexy (p = 0.014) procedures. Reasons for phone calls were categorized under six distinct domains: bowel, pain, activity, medication regimen, urinary, and bleeding. The most frequent concern under each domain included constipation (11.6%), abdominal pain (6.4%), physical activity (8.7%), pain regimen (14.5%), urinary catheter related (13.3%), and vaginal bleeding (12.1%), respectively. The highest volume of phone calls was received for urinary catheter-related issues (10.4%), pain regimen (8.4%), urinary tract infection symptoms (6.7%), constipation (6.7%), vaginal bleeding (6.4%), and voiding issues (5.2%). The volume of phone calls was not impacted by surgical history, medical history, or hospital admission status. Patients discharged with home nursing (11, 6.4%) demonstrated a significantly higher number of phone calls (mean ± SD = 3.82 ± 2.52) than patients discharged home without nursing (153, 88%; 1.89 ± 1.32, respectively; p < 0.001). Thirty-seven percent of callers necessitated an evaluation with a provider or nurse based on their reported concerns. Post-operative patient-initiated telephone calls after FPMRS surgery are common in our practice, occurring in more than half of all patients undergoing a procedure, and specifically more frequent in women discharged home with nursing. Bowel, urinary, and medication-based phone calls account for the highest frequency and volume.