Could Same-Day Postoperative Calls Make A Difference In Patient Satisfaction?

The COVID-19 pandemic resulted in telemedicine becoming commonplace in health-care. Certain specialties are better suited for telemedicine. In specialties like podiatric medicine and surgery, care largely consists of direct hands-on care. The benefits of telemedicine are limited to specific office visit types.

During my 30-year career, I never developed the habit of calling patients the day of or after outpatient surgery. I am readily available to patients via my cell phone or answering service. Typically, my first interaction with a surgical patient is at his or her postoperative office visit. 

The world of health care is changing for the better as patient-centric metrics become essential in assessing the quality of physician care, evaluating hospitals and determining reimbursement.¹ Patient satisfaction is the leading indicator of the quality of care. Customer satisfaction in other industries is directly related to loyalty, company growth and long-term success.^2,3

In a randomized controlled trial recently published by the Journal of Bone and Joint Surgery, Kingery and colleagues examined day of surgery video and phone calls on patient satisfaction.⁴ Three orthopedic surgeons participated in the study, which involved 251 patients who had a variety of standard orthopedic procedures. Researchers assessed three groups for patient satisfaction: patients who had a follow-up phone call the day of surgery; those who had a follow-up video call the day of surgery; and those who weren’t called that day at all. 

The primary outcome measurement was the top box responses on the Consumer Assessment of Healthcare Providers and Systems Surgical Care (S-CAHPS) survey. This survey is a modification of the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey, geared toward a single outpatient surgery episode. "The survey includes questions related to preoperative counseling, quality of interaction with the surgeon, experience on the day of surgery, interaction with the anesthesiologist, quality of immediate postoperative care, and demographic items."⁴

The top-box response rate in the survey for both the video and phone groups was significantly higher than the no-contact group. The satisfaction rate was highest for the video group (85.9 percent) followed by the phone group (71.8 percent) and finally the no-contact group (60.7 percent).⁴ 

Researchers assessed additional outcomes including the likelihood of recommending the surgeon (95.8 percent video group/84.6 percent phone group/64.3 percent no contact group); feeling informed regarding the care plan (76.1 percent video group/64.4 percent phone group/37.3 percent no contact group); and the patient's opinion of the surgeon (94.3 percent patient satisfaction in the video group/89.8 percent in the phone group/59.3 percent in the no contact group).⁴ 

The study authors concluded, "Phone and video calls following discharge are an effective way of enhancing patient satisfaction with the clinical care experience as measured by the S-CAHPS survey. In terms of satisfaction with overall care, video calls may be superior to phone calls."⁴ 

The results from this study are quite telling. I called my surgery scheduler and asked her to start scheduling a quick telemedicine visit with all of my surgery patients later the same day or the following day. 

Since I joined Upperline Health, we are switching electronic health record (EHR) vendors. Upperline Health uses a very user-friendly EHR for telemedicine visits unlike my prior vendor. I work hard to make my patient's experience excellent with high satisfaction but my staff and I are not perfect, and sometimes we fail. Incorporating evidence-based approaches that are simple yet effective to improve the patient’s experience is a slam dunk. I guess you can teach an old dog new tricks. 

Dr. DeHeer is the Residency Director of the St. Vincent Hospital Podiatry Program in Indianapolis. He is a Fellow of the American College of Foot and Ankle Surgeons, a Fellow of the American Society of Podiatric Surgeons, a Fellow of the American College of Foot and Ankle Pediatrics, a Fellow of the Royal College of Physicians and Surgeons of Glasgow, and a Diplomate of the American Board of Podiatric Surgery.

References

1. Shirley ED, Sanders JO. Patient satisfaction: implications and predictors of success. J Bone Joint Surg Am. 2013;95(10):e69.

2. Jones TO, Sasser WE. Why satisfied customers defect. Harv Bus Rev. 1995;73(6):88. 

3. Reichheld FF. The one number you need to grow. Harv Bus Rev. 2003;81(12):46-54, 124. 

4. Kingery MT, Hoberman A, Baron SL, et al. Day-of-surgery video calls and phone calls increase patient satisfaction with outpatient surgery experience: a randomized controlled trial of postoperative communication modalities. J Bone Joint Surg Am. 2021;103(3):243-250.