Using Quality Improvement Principles to Enhance Long-Term Completion of Patient-Reported Outcomes after Ventral Hernia Repair - 19/04/17
, Adil A. Faqih, BS, Michael P. Feng, Richard S. Miller, MD, FACS, Richard A. Pierce, MD, PhD, FACS, Kenneth W. Sharp, MD, FACS, Michael D. Holzman, MD, MPH, FACS, Benjamin K. Poulose, MD, MPH, FACSAbstract |
Background |
Ventral hernia repair (VHR) is a commonly performed surgical procedure. Unfortunately, long-term prospective information about quality of life and outcomes after VHR has been challenging to obtain. Decoupling follow-up from clinical visits via patient-reported outcomes (PROs) has been proposed as a means of achieving better long-term assessments after VHR. The Americas Hernia Society Quality Collaborative (AHSQC) is a national quality improvement (QI) effort in hernia repair that uses PROs to obtain long-term follow-up. However, the modality of PRO engagement to maximize participation has not been well established. A formal QI initiative was undertaken to determine if long-term PRO follow-up could be increased at a single AHSQC site by adding telephone communication to email communication for long-term postoperative VHR assessment.
Methods |
Between September 2015 and July 2016, the long-term (greater than 1 year) AHSQC PRO completion rates after VHR at our institution were analyzed using plan-do-study-act cycles. Two interventions were implemented: contacting patients by telephone and changing timing of telephone calls.
Results |
Two hundred thirty-two patients were identified, of whom 99 (42.7%) met eligibility criteria. Before this initiative, the long-term PRO completion rate was 16.3% in postoperative VHR patients. The completion rate after introducing telephone calls (intervention 1) was 35.7% and after changing the timing of telephone calls (intervention 2), was 55.1%. The mean participation rate was 45.4% (± 9.7%).
Conclusions |
A telephone-based approach markedly improved long-term PRO participation rates in postoperative VHR patients. Ultimately, a combination of email and telephone communication may be necessary to achieve higher levels of PRO follow-up in the VHR population.
Le texte complet de cet article est disponible en PDF.Abbreviations and Acronyms : AHSQC, PDSA, PRO, QI, VHR
Plan
| Disclosure Information: Nothing to disclose. |
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| Disclosures outside the scope of this work: Dr Holzman receives payments for expert testimony from attorneys who request his consultation for individual lawsuits; Dr Pierce receives payments to Vanderbilt from Intuitive Surgical Operations for administrative start-up fee research study participation; and Dr Poulose is a paid consultant for Pfizer Medical and Vanderbilt receives grants from Bard-Davol WL Gore. |
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| Support: Dr Poulose is employed by the Americas Hernia Society Quality Collaborative, which supported the data analyses in this study. |
Vol 224 - N° 2
P. 172-179 - février 2017 Retour au numéro
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