Post-operative telephone review is cost-effective and acceptable to patients.
BACKGROUND
Patients undergoing selective minor emergency and elective procedures are followed up by a nurse-led structured telephone review six weeks post-operatively in our hospital. Our study objectives were to review patients' satisfaction, assess cost-effectiveness and compare our practice with other surgical units in Northern Ireland (NI).


METHODS
Completed telephone follow-up forms were reviewed retrospectively for a three-year period and cost savings calculated. Fifty patients were contacted prospectively by telephone using a questionnaire to assess satisfaction of this follow-up. A postal questionnaire was sent to 68 general and vascular surgeons in NI, assessing individual preferences for patient follow-up.


RESULTS
A total of 1378 patients received a telephone review from September 2005 to September 2008. One thousand one hundred and seventy-seven (85.4%) were successfully contacted, while 201 (14.6%) did not respond despite multiple attempts. One hundred and forty-seven respondents (10.7%) required further outpatient follow-up, thereby saving 1231 outpatient reviews, equivalent to £41,509 per annum. Thirty-nine (78%) patients expected post-operative follow-up, with 29 (58%) expecting this in the outpatient department. However, all patients were satisfied with the nurse-led telephone review. Fifty-three (78%) consultants responded. Those who always, or occasionally, review patients post-operatively varies according to the operation performed, ranging from 2.2% appendicectomy patients to 40.0% for varicose vein surgery.


CONCLUSIONS
Current practice in NI varies, but a significant proportion of patients are not routinely reviewed. This study confirmed that patients expect post-operative follow-up. A nurse-led telephone review service is acceptable to patients, cost-effective and reduces the number of unnecessary outpatient reviews.
Department of Surgery, Mater Hospital, Belfast Health and Social Care Trust, Crumlin Road, Belfast BT14 6AB. rgray05@qub.ac.uk
R T
RT
Gray
M K
MK
Sut
S A
SA
Badger
C F
CF
Harvey
D003362:Cost-Benefit Analysis; D006801:Humans; D007407:Interviews as Topic / Q000379:methods*; D009660:Northern Ireland; D024802:Nurse's Role; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D011182:Postoperative Care / Q000191:economics* / Q000379:methods / Q000451:nursing*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*