Department of Orthopaedic Surgery, University of Arkansas for Medical Sciences, Little Rock, AR.
J Arthroplasty. 2019 Jul;34(7):1303-1306. doi: 10.1016/j.arth.2019.02.067. Epub 2019 Mar 8.
Early discharge after joint arthroplasty requires additional resources to manage patients safely after surgery. Patient concerns must be addressed during nonbusiness hours to keep patients out of the emergency department and avoid readmissions. The goal of our study was to determine how type of system is utilized in a busy early discharge joint replacement practice.
In our total joint program, we have utilized a Google phone number to give patients access to a member of the surgical team after business hours and on weekends. The duration, chief complaint, and resolution of from the phone calls were collected prospectively for 3 months (July 3, 2017-October 3, 2017).
Sixty-eight calls were received from 55 patients during the 3-month study period. Three hundred twenty-five cases were performed. The average duration of a call was 3.9 minutes. The average length of time from surgery to call was 17.5 days (range 0-442 days). Suboptimal health literacy was associated with increased calls within the first week after surgery (odds ratio = 4.1, 95% confidence interval = 1.2-14.5, P = .022). A chief complaint of pain was associated with primary versus revision surgery. (odds ratio = 3.23, 95% confidence interval = 1.08-9.86).
An "after-hours" telephone contact service with a member of the surgical team may help avoid unnecessary emergency department visits. About one phone call was received per day, with an average duration of 3.9 minutes per call. These additional resources are necessary to maintain patient safety and satisfaction in early discharge joint replacement.
关节置换术后提前出院需要额外的资源来确保患者术后安全。为了避免患者去急诊并再次入院，必须在非工作时间解决患者的担忧。我们的研究目的是确定在繁忙的提前出院关节置换实践中使用哪种系统。
在我们的全关节项目中，我们使用了一个谷歌电话号码，以便患者在非工作时间和周末也能联系到手术团队的成员。前瞻性地收集了 3 个月（2017 年 7 月 3 日至 2017 年 10 月 3 日）内的通话持续时间、主要投诉和解决情况。
在 3 个月的研究期间，55 名患者共接到 68 个电话。共进行了 325 例手术。平均通话时间为 3.9 分钟。从手术到电话的平均时间为 17.5 天（范围 0-442 天）。较差的健康素养与术后第一周内增加的电话量有关（比值比=4.1，95%置信区间=1.2-14.5，P=0.022）。疼痛是主要投诉与初次手术与翻修手术有关。（比值比=3.23，95%置信区间=1.08-9.86）。
与手术团队成员的“下班后”电话联系服务可能有助于避免不必要的急诊就诊。平均每天接到一个电话，每个电话的平均持续时间为 3.9 分钟。这些额外的资源对于维持提前出院关节置换患者的安全和满意度是必要的。
