Using Quality Improvement Principles to Enhance Long-Term Completion of Patient-Reported Outcomes after Ventral Hernia Repair

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• 作者：Nishant Ganesh Kumar ; BS ; ^{nishant.ganesh.kumar@vanderbilt.edu} ; 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 ; FACS
• 关键词：AHSQC ; Americas Hernia Society Quality Collaborative ; PDSA ; plan-do-study-act ; PRO ; patient-reported outcome ; QI ; quality improvement ; VHR ; ventral hernia repair
• 刊名：Journal of the American College of Surgeons
• 出版年：2017
• 出版时间：February 2017
• 年：2017
• 卷：224
• 期：2
• 页码：172-179
• 全文大小：417 K
• 卷排序：224

文摘

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.MethodsBetween 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.ResultsTwo 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%).ConclusionsA 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.