title: Patient satisfaction with post-operative telephone calls after Mohs micrographic surgery: a New Zealand and U.K. experience.
abstract: BACKGROUND
  Mohs micrographic surgery (MMS) is regarded as the gold standard for treating nonmelanoma skin cancers of the head and neck. Surgical interventions can generate anxiety for patients and efforts to minimize this may enhance their experience.
  
  
  OBJECTIVE
  To assess the perceived patient benefits of post-operative telephone follow-up (TFU) calls after MMS.
  
  
  METHODS
  A prospective, controlled, questionnaire-based assessment of patient satisfaction with TFU calls in patients undergoing MMS was conducted in two centres (New Zealand and U.K.) over a 4-month period from June to September 2011. All individuals in the study group were telephoned on the evening of their surgery by the operating surgeon. Questionnaires were completed by all patients at the time of suture removal.
  
  
  RESULTS
  The median Likert score on a 10-point scale relating to patients' perception of the TFU service was higher in the study group compared with the control group (10 vs. 9), with no correlation to closure type of the surgical defect. Overall patient satisfaction with the TFU service was high (94% New Zealand; 96% U.K.), and this was independent of the patient's place of residence. There was no age or sex difference in the minority who did not find the TFU call helpful. The majority of patients felt the best time to call was the night of the surgery (89% New Zealand; 94% U.K.). All patients who had undergone MMS previously found the TFU call just as useful as the first time. The majority of patients (94% New Zealand; 96% U.K.) did not need to call the doctor post-surgery, although 7% of patients in the control group rang the surgeon with issues that could have been readily dealt with by the TFU service. Comparatively, more patients from the U.K. felt their satisfaction would have been the same with a nurse-led TFU call service compared with New Zealand (94% vs. 66%). A significant proportion of those who preferred to be called by the doctor underwent cutaneous flap closures. Patients felt that other specialities that perform surgical procedures under local anaesthetic should adopt a TFU service post-surgery.
  
  
  CONCLUSIONS
  TFU calls post-MMS are a cost-effective, time-efficient way of achieving high levels of patient satisfaction.
authors.affiliation: Skin Cancer Institute, Dermatological Surgical Unit, 171 Cameron Road, Tauranga, New Zealand. juber.hafiji@hotmail.co.uk
authors.forename: J
authors.initials: J
authors.lastname: Hafiji
authors.forename: P
authors.initials: P
authors.lastname: Salmon
authors.forename: W
authors.initials: W
authors.lastname: Hussain
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D004739:England; D005246:Feedback; D005260:Female; D006258:Head and Neck Neoplasms / Q000523:psychology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015580:Mohs Surgery / Q000523:psychology* / Q000592:standards; D009520:New Zealand; D017060:Patient Satisfaction; D011182:Postoperative Care / Q000523:psychology* / Q000592:standards; D011446:Prospective Studies; D019114:Remote Consultation / Q000592:standards*; D012878:Skin Neoplasms / Q000523:psychology / Q000601:surgery*; D011795:Surveys and Questionnaires; D013689:Telephone; D055815:Young Adult