31 Patient -initiated telephone calls before and after introduction of an enhanced recovery after surgery (ERAS) protocol for female pelvic reconstructive surgery

Abstract

To compare the volume of phone calls related to the perioperative care pre- and post-implementation of Enhanced Recovery after Surgery (ERAS). This is a retrospective chart review of women undergoing surgery by fellowship-trained urogynecologists at a single tertiary-care center where Enhanced Recovery after Surgery (ERAS) was implemented in January 2018. Patients who underwent surgery with overnight stay were identified prior to the implementation (“pre-ERAS,” January 1 to June 30, 2017, inclusive) and compared to the same period of time after implementation (“post-ERAS,” January 1 to June 30, 2019.) Preoperative and postoperative phone calls were reviewed and categorized by reason for call. Differences between the two groups were compared with a Student’s t-test, if normally distributed, or with a Mann-Whitney U test if not. Categorical outcomes were reported with a percentage and compared with a chi square test with an alpha level of 0.05. This is a retrospective chart review of women undergoing surgery by fellowship-trained urogynecologists at a single tertiary-care center where Enhanced Recovery after Surgery (ERAS) was implemented in January 2018. Patients who underwent surgery with overnight stay were identified prior to the implementation (“pre-ERAS,” January 1 to June 30, 2017, inclusive) and compared to the same period of time after implementation (“post-ERAS,” January 1 to June 30, 2019). Preoperative and postoperative phone calls were reviewed and categorized by reason for call. Differences between the two groups were compared with a Student’s t-test, if normally distributed, or with a Mann-Whitney U test if not. Categorical outcomes were reported with a percentage and compared with a chi square test with an alpha level of 0.05. Our study found no difference in pre- or post-operative calls with the implementation of ERAS. Despite patient education being an essential component of ERAS and patients being provided detailed written and verbal instructions, our study demonstrates a high volume of phone calls in our practice and identifies opportunities for improving preoperative counseling. Additionally, despite the high volume of calls regarding pain management, the majority of patients in our practice are satisfied with the pain management and require few, if any, narcotics post-operatively. By focusing on common concerns, we may be able to improve patients’ surgical experience and reduce the burden of office phone calls.