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短信联系对门诊手术医疗安全的效率:回顾性研究。

Efficiency of Text Message Contact on Medical Safety in Outpatient Surgery: Retrospective Study.

机构信息

Department of Anesthesiology and Critical Care, Rouen University Hospital, Rouen, France.

Le Havre Hospital, Le Havre, France.

出版信息

JMIR Mhealth Uhealth. 2020 Sep 10;8(9):e14346. doi: 10.2196/14346.

Abstract

BACKGROUND

Establishing pre- and postoperative contact with patients is part of successful medical management in outpatient surgery. In France, this is mostly done via telephone. Automated information with short message service (SMS) reminders might be an interesting alternative to increase the rate of compliance with preoperative instructions, but no study has shown the safety of this approach.

OBJECTIVE

The objective of this study was to evaluate the impact of pre- and postoperative automated information with SMS reminders on medical safety in outpatient surgery.

METHODS

We conducted a retrospective, single-center, nonrandomized, controlled study with a before-after design. All adult patients who had outpatient surgery between September 2016 and December 2017 in our university hospital center were included. Before April 2017, patients were contacted by telephone by an outpatient surgery nurse. After April 2017, patients were contacted by SMS reminder. All patients were contacted the day before and the day after surgery. Patients contacted by SMS reminder were also contacted on day 7 after surgery. The primary end point was the conversion rate to full-time hospitalization. Secondary end points were hospitalization causes (anesthetic, surgical, organizational) and hospitalization costs.

RESULTS

A total of 4388 patients were included, 2160 before and 2228 after the introduction of SMS reminders. The conversion rate to full-time hospitalization was 34/4388 (0.77%) with a difference between SMS group (8/2228, 0.36%) and telephone group (26/2160, 1.20%). The cost of SMS reminders was estimated as half that of telephone calls.

CONCLUSIONS

In this work, we report a decrease in the rate of conversion to full-time hospitalization with the use of pre- and postoperative SMS reminders. This new approach could represent a safe and cost-effective method in an outpatient surgery setting.

摘要

背景

在门诊手术中,与患者建立术前和术后联系是成功医疗管理的一部分。在法国,这主要通过电话完成。使用带有短消息服务(SMS)提醒的自动信息可能是提高术前医嘱依从率的一种有趣选择,但尚无研究表明这种方法的安全性。

目的

本研究旨在评估门诊手术中使用术前和术后自动短信提醒对医疗安全的影响。

方法

我们进行了一项回顾性、单中心、非随机、对照研究,采用前后设计。所有 2016 年 9 月至 2017 年 12 月期间在我们大学医院中心接受门诊手术的成年患者均纳入研究。在 2017 年 4 月之前,由门诊手术护士通过电话联系患者。在 2017 年 4 月之后,通过短信提醒联系患者。所有患者在手术前一天和手术后一天都会被联系。通过短信提醒联系的患者还会在手术后第 7 天被联系。主要终点是转为全时住院的转化率。次要终点是住院原因(麻醉、手术、组织)和住院费用。

结果

共纳入 4388 例患者,其中 2160 例在引入短信提醒之前,2228 例在引入短信提醒之后。转为全时住院的转化率为 34/4388(0.77%),短信组(8/2228,0.36%)与电话组(26/2160,1.20%)之间存在差异。短信提醒的成本估计为电话的一半。

结论

在这项工作中,我们报告使用术前和术后短信提醒可降低全时住院的转化率。这种新方法在门诊手术环境中可能是一种安全且具有成本效益的方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cd15/7516679/9d9fc4021497/mhealth_v8i9e14346_fig1.jpg

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