Interdisciplinary Orthopaedics, Department of Orthopaedics, Aalborg University Hospital, Aalborg; Laboratory for Welfare Technologies - Digital Health & Rehabilitation, ExerciseTech, Department of Health Science and Technology, Aalborg University, Aalborg East.
Interdisciplinary Orthopaedics, Department of Orthopaedics, Aalborg University Hospital, Aalborg.
Acta Orthop. 2024 May 17;95:225-232. doi: 10.2340/17453674.2024.40707.
Post-discharge inquiries to the hospital are predominantly conducted through phone calls. The rigid timing of these calls is inconvenient for patients and disrupts the workflows of healthcare professionals. The aim of this study was to investigate the effect of a team-based digital communication intervention (eDialogue) facilitated through a messenger-like commercial solution on patient-initiated phone calls to the hospital after discharge. Secondarily, we investigated other patient-initiated contacts, patients' perception of continuity of care, and their perception of feeling safe and satisfied after hospital discharge.
On the day of discharge, 70 surgically treated orthopedic patients were randomized to the intervention group with access to eDialogue (n = 35) or the control group with standard communication pathways by phone call (n = 35) for the following 8 weeks. Through eDialogue, the intervention group had access to team-based asynchronous digital communication in text and photos with healthcare professionals across disciplines and sectors. Inclusion criteria were discharge to own home and receipt of rehabilitation services from both hospital and primary care after discharge.
We found a significant reduction in the mean number of patient-initiated phone calls to the hospital from 2.3 (95% confidence interval [CI] 1.4-4.1) in the control group to 0.5 (CI 0.3-1.0) in the intervention group (P = 0.004). Across groups, patients reported similar perceptions of continuity of care; however, the participants in the intervention group expressed significantly improved perceptions of, and satisfaction with, access to healthcare after discharge.
Access to eDialogue reduced patient-initiated phone calls to the hospital, enhanced patient satisfaction with healthcare accessibility, and did not compromise patients' perception of continuity of care after discharge compared with standard communication pathways.
出院后的医院随访主要通过电话进行。这些电话的时间安排较为死板,对患者来说不方便,也会打乱医疗保健专业人员的工作流程。本研究旨在探讨通过类似于信使的商业解决方案提供的基于团队的数字通信干预(eDialogue)对出院后患者主动拨打医院电话的影响。其次,我们还调查了其他患者主动联系、患者对连续护理的感知,以及他们在出院后的安全感和满意度。
在出院当天,70 名接受手术治疗的骨科患者被随机分配到干预组(n=35)或对照组(n=35),干预组可通过 eDialogue 获得团队基于异步数字通信的文本和照片与跨学科和部门的医疗保健专业人员进行交流,对照组仅通过电话进行标准的沟通方式。纳入标准为出院后返回家中,并在出院后接受医院和初级保健的康复服务。
我们发现,与对照组(2.3[95%置信区间 1.4-4.1])相比,干预组(0.5[0.3-1.0])患者主动拨打医院电话的次数显著减少(P=0.004)。两组患者对连续护理的感知相似;然而,干预组的参与者对出院后获得医疗保健的可及性表示出明显改善的感知和满意度。
与标准沟通途径相比,使用 eDialogue 可以减少患者主动拨打医院的电话次数,提高患者对医疗保健可及性的满意度,且不会影响患者对出院后连续性护理的感知。