Feasibility and Impact of Follow-up Phone Calls After Colon and Rectal Surgery: A Single-Center Experience
Chau M. Hoang MD, Karim Alavi MD MPH, Paul R. Sturrock MD, Jennifer L. Guertin PA, Brett M. Baker MD MBA, David Meyer MD MS, Justin A. Maykel MD, Jennifer S. Davids MD
Division of Colon and Rectal Surgery, UMass Medical School, Worcester, MA, USA
Background: Half of 30-day readmissions after colorectal surgery occur within 7 days of discharge. We aimed to 1) determine the feasibility of follow-up phone calls from a resource-limited, urban tertiary hospital and 2) assess readmission rate and time-to-readmission.
Methods: Patients were contacted by a physician assistant via telephone 48 hours after discharge. Descriptive statistics, univariate and Kaplan-Meier analyses were used.
Results: Of the 184 patients discharged to home after elective colorectal surgery between 11/2015-11/2016, mean age was 58 years and 46% were male. Procedures included colectomy (43%), low anterior resection (14%), ileostomy takedown (12%), colostomy takedown (5%), and other (25%). Primary diagnoses included malignancy (50%), diverticular disease (20%), other benign (17%) and inflammatory bowel disease (13%). Surgical approach included laparoscopic (63%), robotic (12%) and open (25%). 67% of patients were reached; 33% did not receive a phone call because of early readmission (5%), early post-op appointment (7%), missed call window (14%), or patients were unreachable (7%). Non-elective 30-day readmission in the phone-call group was 9% (11/124) compared to 32% (19/60) in the no-call group (p<0.001). Median time-to-readmission was 8 days in the phone-call group compared to 5 days in the no-call group (p=0.21).
Conclusion: Follow-up phone call after hospital discharge is feasible in an urban tertiary hospital with limited available personnel. A prospective randomized controlled trial is needed to determine the broader impact of phone-call interventions on outcomes.
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