Institution-initiated text messaging can reduce unplanned emergency department visits after appendectomy

D'Cruz, Roshan; MacDonald, Lisa-Qiao; N, Zisa; Zomorrodi, Arezoo; Murren-Boezem, Joanne; Atanda, Alfred; Hirschfeld, Fiona; Berman, Loren

doi:10.1016/j.jpedsurg.2020.09.046

Cited by 11 publications

(4 citation statements)

References 26 publications

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“…Clinicians experience uncertainty regarding caregivers' ability to assess their child's recovery, and simple interventions to improve communication between the health care system and the caregiver reduce post-operative ED presentation by up to 50% [4,10]. Moreover, we propose an enriched form of communication between the health care system, caregiver and patient, and with such a system it is anticipated that unnecessary ED presentation be reduced even further.…”

Section: Discussionmentioning

confidence: 99%

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Consumer wearables data impact pediatric surgery clinicians’ remote management

Carter,

Linton,

Zeineddin

et al. 2023

Preprint

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Purpose Integration of consumer wearables data has the potential to inform clinicians’ remote assessment of postoperative patients. This multi-institutional study evaluated the impact of adding objective recovery data from consumer wearables to postoperative telephone encounters on clinicians’ management.Methods Three telephone scenarios of post-appendectomy patients were presented to clinicians at five children’s hospitals. Each scenario was then supplemented with wearable data concerning for or reassuring against postoperative complication. Clinicians rated likelihood of ED referral and confidence in decision-making.Results Thirty-four clinicians participated. Compared to the scenario alone, the addition of reassuring wearable data resulted in decrease in likelihood of ED referral for all three scenarios (p < 0.01). When presented with concerning wearable data, there was significant increase in the likelihood of ED referral for two of three scenarios (p = 0.72, p = 0.02, p < 0.001). With the addition of wearable data, 76–88% of clinicians reported increased confidence in their recommendations.Conclusion The addition of wearable data to simulated telephone scenarios for post-discharge pediatric surgery patients impacted clinicians’ remote patient management and increased clinician confidence. Wearable devices are capable of providing real-time measures of recovery, which can be employed as a post-operative monitoring tool to reduce delays in care and avoidable health care utilization.

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Section: Discussionmentioning

confidence: 99%

“…In result, they are dependent upon their subjective assessment of the child's well-being and the child's ability to communicate their symptoms. It has been shown that the subjective nature of home-monitoring contributes to both avoidable healthcare utilization and delays in treatment [1][2][3][4].…”

Section: Introductionmentioning

confidence: 99%

Consumer wearables data impact pediatric surgery clinicians’ remote management

Carter,

Linton,

Zeineddin

et al. 2023

Preprint

View full text Add to dashboard Cite

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“…In addition, unplanned hospital utilization after discharge was 23.4% in our series. The clinical importance of unplanned hospital visits has been investigated in the field of postoperative care [ 14 , 15 , 16 , 17 ]. Unplanned hospital visits after PD should be considered as a complication or an indicator of the quality of healthcare, just like hospital readmission.…”

Section: Discussionmentioning

confidence: 99%

“…In addition to readmission, unplanned hospital visits are also troublesome postoperative events for patients after discharge [ 14 , 15 , 16 , 17 ]. The event not only impacts patients’ postoperative recovery and satisfaction but also increases the financial burden and additional resource utilization [ 3 , 4 , 5 , 7 , 18 ].…”

Section: Introductionmentioning

confidence: 99%

The Severity of Postoperative Pancreatic Fistula Predicts 30-Day Unplanned Hospital Visit and Readmission after Pancreaticoduodenectomy: A Single-Center Retrospective Cohort Study

et al. 2022

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Background: Unplanned hospital visits (UHV) and readmissions after pancreaticoduodenectomy (PD) impact patients’ postoperative recovery and are associated with increased financial burden and morbidity. The aim of this study is to identify predictive factors related to these events and target the potentially preventable UHV and readmissions. Methods: We enrolled 518 patients in this study. Characteristics were compared between patients with or without UHV and readmissions. Results: The unplanned visit and readmission rate was 23.4% and 15.8%, respectively. Postoperative pancreatic fistula (POPF) grade B or C, the presence of postoperative biliary drainage, and reoperation were found to be predictive factors for UHV, whereas POPF grade B or C and the presence of postoperative biliary drainage were independently associated with hospital readmission. The most common reason for readmission was an infection, followed by failure to thrive. The overall mortality rate in the readmission group was 4.9%. Conclusions: UHV and readmissions remain common among patients undergoing PD. Patients with grade B or C POPF assessed during index hospitalization harbor an approximately two-fold increased risk of subsequent unplanned visits or readmissions compared to those with no POPF or biochemical leak. Proper preventive strategies should be adopted for high-risk patients in this population to maintain the continuum of healthcare and improve quality.

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