Efficacy of Telephone Follow-Up in Children Tonsillectomy with Day Surgery

Xin, Yan Ping; Li, Xin; Du, JinDong; Cheng, Jie; Chun-yan, YI; Mao, Huadong

doi:10.1007/s12098-018-2813-y

Cited by 18 publications

(20 citation statements)

References 15 publications

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“…Although, due to the large sample size, specific recommendations to each family were not analyzed, opportunities to better educate families on appropriate interventions or need for communication with an otolaryngology team member were afforded by the postoperative phone call. Xin and colleagues 13 noted that a POD 1 T&A phone intervention reduced early‐stage pain intensity felt to relate to the opportunity for the nurse to emphasize improved analgesia to promote better hydration.…”

Section: Discussionmentioning

confidence: 99%

“…3,[10][11][12] Follow-up phone calls have been shown to be an efficient and cost-effective means of monitoring children after outpatient surgery. 12,13 The calls not only evaluate for potential problems and complications, but they also provide an opportunity to relay additional information to families on managing pain, postoperative nausea and vomiting, and other postoperative concerns. [2][3][4][5] In addition, the call may serve to waylay anxiety experienced by family members and may serve to provide reassurance and a sense of caring.…”

Section: Introductionmentioning

confidence: 99%

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Outcomes of a postoperative day one call to families after adenotonsillectomy in children

Billings

Bhushan

Berkowitz

et al. 2022

Laryngoscope Investig Oto

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Objective To examine the outcomes of a postoperative day one (POD 1) phone call to families of ambulatory surgical patients, as a means of guiding clinical interventions and quality initiatives, with a focus on children undergoing adenotonsillectomy (T&A). Methods Retrospective analysis of outcomes of a POD 1 questionnaire completed in children <18 years of age undergoing T&A at a tertiary care children's hospital over a 3‐year period (August 14, 2018–August 31, 2021). Results Responses to the questionnaire were obtained for a total of 1428/3464 (41.2%) children undergoing T&A during the study period. There was no difference in gender, age at surgery, race, ethnicity, insurance product, or preoperative diagnosis for those whose caregiver responded to the questionnaire versus those who did not. Parent responses included 84 (5.9%) who reported problems or concerns postdischarge. These included 18 (1.3%) patients unable to take their pain medication, 9 (0.6%) refusing oral intake, 28 (2.0%) with postoperative emesis, 27 (1.9%) with fevers, and 6 (0.4%) with a change in breathing. A total of 75/122 (61.5%) who reported pain were taking their pain medication as directed. Nineteen (1.3%) patients were noted to have bleeding after surgery, including 4 (21.5%) with nosebleeds, and 12 (63.2%) with oral cavity bleeding requiring no interventions. Conclusions The POD 1 questionnaire identified patients with common concerns and complications after T&A. Although most of these concerns were infrequent, it afforded the clinical team the opportunity to provide additional education and instructions on care and management to caregivers after their child's surgical procedure.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Outcomes of a postoperative day one call to families after adenotonsillectomy in children

Billings

Bhushan

Berkowitz

et al. 2022

Laryngoscope Investig Oto

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“…Second, TTTM is designed to support caregivers across the full perioperative period (ie, before, day of, and for 2 weeks after their child’s surgery) and was assessed using multiple measures (eg, analgesic use, caregiver self-efficacy, child pain levels, and health service use). Among technology-based pediatric-related intervention studies, most have measured only child and system outcomes [ 38 ] or measured them at only 1 postoperative time point [ 39 , 40 ]. Our comprehensive findings suggest that patient-level (eg, child pain) and system-level (eg, hospital visits) outcomes should be complemented with an assessment of the quality-of-care measures that help us to understand caregiver experiences (eg, caregiver distress) and behaviors across the perioperative period.…”

Section: Discussionmentioning

confidence: 99%

The Impact of a Text Messaging Service (Tonsil-Text-To-Me) on Pediatric Perioperative Tonsillectomy Outcomes: Cohort Study With a Historical Control Group

Wozney¹,

Vakili²,

Chorney³

et al. 2022

JMIR Perioper Med

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Background Tonsillectomy is a common pediatric surgical procedure performed in North America. Caregivers experience complex challenges in preparing for their child’s surgery and coordinating care at home and, consequently, could benefit from access to educational resources. A previous feasibility study of Tonsil-Text-To-Me, an automated SMS text messaging service that sends 15 time-sensitive activity reminders, links to nutrition and hydration tips, pain management strategies, and guidance on monitoring for complications, showed promising results, with high levels of caregiver satisfaction and engagement. Objective This study aimed to pilot-test Tonsil-Text-To-Me in a real-world context to determine whether and how it might improve perioperative experiences and outcomes for caregivers and patients. Methods Caregivers of children aged 3 to 14 years undergoing tonsillectomy were included. Data from a historical control group and an intervention group with the same study parameters (eg, eligibility criteria and surgery team) were compared. Measures included the Parenting Self-Agency Measure, General Health Questionnaire-12, Parents’ Postoperative Pain Measure, Client Satisfaction Questionnaire-8, and engagement analytics, as well as analgesic consumption, pain, child activity level, and health service use. Data were collected on the day before surgery, 3 days after surgery, and 14 days after surgery. Participants in the intervention group received texts starting 2 weeks before surgery up to the eighth day after surgery. Descriptive and inferential statistics were used. Results In total, 51 caregivers (n=32, 63% control; n=19, 37% intervention) who were predominately women (49/51, 96%), White (48/51, 94%), and employed (42/51, 82%) participated. Intervention group caregivers had a statistically significant positive difference in Parenting Self-Agency Measure scores (P=.001). The mean postoperative pain scores were higher for the control group (mean 10.0, SD 3.1) than for the intervention group (mean 8.5, SD 3.7), both of which were still above the 6/15 threshold for clinically significant pain; however, the difference was not statistically significant (t39=1.446; P=.16). Other positive but nonsignificant trends for the intervention group compared with the control group were observed for the highest level of pain (t39=0.882; P=.38), emergency department visits (χ22=1.3; P=.52; Cramer V=0.19), and other measures. Engagement with resources linked in the texts was moderate, with all but 1 being clicked on for viewing at least once by 79% (15/19) of the participants. Participants rated the intervention as highly satisfactory across all 8 dimensions of the Client Satisfaction Questionnaire (mean 29.4, SD 3.2; out of a possible value of 32.0). Conclusions This cohort study with a historical control group found that Tonsil-Text-To-Me had a positive impact on caregivers’ perioperative care experience. The small sample size and unclear impacts of COVID-19 on the study design should be considered when interpreting the results. Controlled trials with larger sample sizes for evaluating SMS text messaging interventions aimed to support caregivers of children undergoing tonsillectomy surgery are warranted.

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“…Reports show that postoperative telephone calls are a successful means of follow-up, and they provide a means to assess outcomes after common ambulatory surgical procedures like T&A. [2][3][4][5][6][7][8] The postoperative phone call allows for decreased time away from work, school, and day care for family members and patients and also provides a satisfying, preferred means of postoperative assessment when compared to traditional office visits. 2,4 In person, postoperative clinic visits after outpatient surgery have not been shown to identify problems or require interventions.…”

Section: Introductionmentioning

confidence: 99%

Outcomes of a Postoperative Data‐Extraction Questionnaire After Adenotonsillectomy in Children

et al. 2021

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Objectives/Hypothesis: To evaluate outcomes of a postoperative telephone questionnaire for children who underwent adenotonsillectomy (T&A). To determine whether episodes of postoperative hemorrhage were not captured until the call, and whether this impacted knowledge of physician rates of hemorrhage.Study Design: Retrospective database analysis.Methods: Retrospective analysis of outcomes of an 11-question data extraction tool utilized at a tertiary care children's hospital for follow-up in T&A patients <18 years of age over a 2-year period. Sub-analysis of positive responses to the question asking about incidence of postoperative hemorrhage.Results: During the study period, 1,068/3,142 (34.0%) parents responded to the phone call. Median age was 6.0 years (interquartile range [IQR] 4.0-8.2), and 566 (53.0%) were male. Ninety (8.4%) noted that the child was still snoring, but only 9 (0.84%) reported signs of obstructed breathing. A total of 402 (37.6%) reported a voice change after surgery. Most children (n = 885, 82.9%) did not receive opioid analgesics, and 252 (23.6%) received acetaminophen/ibuprofen 7 days postoperatively. Return visits to the emergency department were reported in 149 patients; primarily for hemorrhage in 46 (30.8%). In 7 (15.2%) patients, the hemorrhage event was not recorded until the call. The majority-of respondents (n = 1,031, 96.5%) were satisfied with the outcome of the procedure.Conclusions: The postoperative T&A tool provided a means of gathering information on success and satisfaction with surgical outcomes. Children were able to be managed primarily with acetaminophen and ibuprofen. Most complications were captured in the electronic record, although some episodes of hemorrhage were not noted until the call, emphasizing the importance of follow-up.

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Efficacy of Telephone Follow-Up in Children Tonsillectomy with Day Surgery

Cited by 18 publications

References 15 publications

Outcomes of a postoperative day one call to families after adenotonsillectomy in children

Outcomes of a postoperative day one call to families after adenotonsillectomy in children

The Impact of a Text Messaging Service (Tonsil-Text-To-Me) on Pediatric Perioperative Tonsillectomy Outcomes: Cohort Study With a Historical Control Group

Outcomes of a Postoperative Data‐Extraction Questionnaire After Adenotonsillectomy in Children

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