Automated patient assessments after outpatient surgery using an interactive voice response system.
OBJECTIVE
To test the feasibility and utility of an interactive voice response system (IVRS) for monitoring patients after outpatient surgery.


METHODS
We studied consecutive patients undergoing gynecologic day surgery. The IVRS called patients on the first postoperative day and asked them if they were experiencing new problems. Feasibility was assessed in terms of call responses and acceptance by patients. Utility was measured in terms of the ability of the IVRS to identify adverse events (AEs), defined as procedure-related symptoms requiring a physician or hospital visit. We contacted patients 30 days later to elicit their perceptions of the IVRS and determine AE status.


RESULTS
Follow-up was complete for 249 of 270 enrolled patients (92%). The IVRS successfully contacted 130 patients (52%). Of the 22 patients (17%) who required a follow-up phone call, 9 had a new problem related to surgery, 7 had new or worsening symptoms, 6 wanted to speak with a nurse, and 1 had a medication-related problem. Patients remembering the automated call (n = 96) reported the system easy to use (82%) and comprehend (86%). Most patients (68%) preferred the IVRS to a personal follow-up call (probability greater than 50%, P <.001). AEs occurred in 40 patients (16%; 95% confidence interval = 12%, 21%). The IVRS did not identify any AEs because 90% of these occurred after the automated call.


CONCLUSIONS
An IVRS-based method of monitoring outpatient surgery patients is feasible. To improve utility, calls must occur later than first postoperative day.
Forster
Alan J
AJ
Department of Medicine, University of Ottawa, Ontario, Canada. aforster@ohri.ca
LaBranche
Rinda
R
McKim
Robert
R
Faught
John Wylam
JW
Feasby
Thomas E
TE
Janes-Kelley
Selikke
S
Shojania
Kaveh G
KG
van Walraven
Carl
C
D000328:Adult; D000359:Aftercare / Q000379:methods*; D000556:Ambulatory Surgical Procedures; D001331:Automation; D005260:Female; D013509:Gynecologic Surgical Procedures; D006801:Humans; D008875:Middle Aged; D009730:Nursing Assessment / Q000379:methods; D011183:Postoperative Complications / Q000175:diagnosis*; D011446:Prospective Studies; D049250:Speech Recognition Software; D013689:Telephone; D014584:User-Computer Interface