Summary
Introduction
Preparing patients for surgery is a task healthcare organizations strive to optimize.
Electronic messaging (EM) provides an opportunity for streamlining components of this
arduous process. Our study aims to evaluate our early experience in utilizing EM to
provide preoperative information to pediatric urology patients.
Objective
To assess the effectiveness of EM in preparing patients for pediatric urologic surgery.
Study design
This study compared a 6-week pilot program of EM (Figure 1) with traditional nurse
phone calls (NPC) in preoperative instruction of pediatric urology patients. The same
preoperative instructional information was provided via either source. Data collected
included time and resources used by the healthcare system and patient/parent satisfaction.
Results
The EM group included 98 patients, while the NPC group included 212 patients. Case
cancellation rate between the two cohorts was similar, with a 6.67% cancellation rate
in the EM cohort and a 10.55% cancellation rate in the NPC cohort (z = −1.137, p = 0.25).
There were 4 EM-related operating room delays with an average case delay of 31.5 min
(5–60 min). Twenty-four (24%) EM patients/families required secondary phone calls,
while 106 (50%) NPC required a follow up phone call (p < 0.01). 94% of EM participants
recommended EM for future perioperative instructions. Accounting for the average case
volume within our entire children's hospital, the average total daily cost for EM
is $5.96/day, as compared to an average total cost of $87.78/day to perform NPC. This
represents an estimated cost savings of $81.82 per day or $21,273.20 per year, based
upon average total case volume at our institution.
Discussion
In our initial experience, EM effectively communicates the necessary preoperative
information to patients and/or families undergoing pediatric urology surgery. Our
results demonstrate low case cancellation and delay rates and high patient/family
satisfaction. Also demonstrated was the cost savings by replacing the NPC with EM.
A great benefit of EM was the increased time it provided for nurses to perform other
patient care duties, which is important given our current nationwide nursing shortage.
Limitations of the study included a narrow scope assessing only pediatric urology
patients as well as a short study period. Further studies will further define and
refine the role of perioperative EM.
Conclusion
Changing to an EM system for preoperative instructions in the pediatric urology population
met with a high degree of patient satisfaction and decreased costs for healthcare
systems without increasing case delay or cancellation rates.
Keywords
Abbreviations:
EM (Electronic messaging), NPC (Nursing phone call), NPO (Nil per os), SMS (Short message service)To read this article in full you will need to make a payment
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References
- Use of mobile phone text message reminders in health care services: a narrative literature review.J Med Internet Res. 2014; 16: e222
- Digital divide persists even as Americans with lower incomes make gains in tech adoption.([Webpage]) Pew Research Center, Washington D.C2021 June 22 (2021 [cited 2022 January 13,2022]; June 22, 2021:[Available from:)
- Implementation of a text message to improve adherence to clinic and social service appointments.J Int Assoc Phys AIDS Care. 2019; 18 (232595821987016)
- Mobile phone text messaging reminder decreases the rate of nonattendance at a preoperative anaesthesia clinic.Eur J Anaesthesiol | EJA. 2017; 34: 566-567
- An automated text messaging system (Tonsil-Text-To-Me) to improve tonsillectomy perioperative experience: exploratory qualitative usability and feasibility study.JMIR Perioperative Medicine. 2020; 3: e14601
- Glob Health. 2006; 2: 9
- SMS reminders improve adherence to oral medication in type 2 diabetes patients who are real time electronically monitored.Int J Med Inf. 2012; 81: 594-604
- Smoking cessation support delivered via mobile phone text messaging (txt2stop): a single-blind, randomised trial.Lancet. 2011; 378: 49-55
- Addressing HIV knowledge, risk reduction, social support, and patient involvement using SMS: results of a proof-of-concept study.J Health Commun. 2012; 17: 128-145
- A daily SMS reminder increases adherence to asthma treatment: a three-month follow-up study.Respir Med. 2010; 104: 166-171
- Use of text-message reminders to improve participation in a population-based breast cancer screening program.J Med Syst. 2014; 38
- Post-discharge follow-up using text messaging within an enhanced recovery program after colorectal surgery.J Visc Surg. 2016; 153: 249-252
- Clinical interest and economic impact of preoperative SMS reminders before ambulatory surgery: a propensity score analysis.J Med Syst. 2018; 42
- The consumer experience.(Available from:)
- Comparison of an SMS text messaging and phone reminder to improve attendance at a health promotion center: a randomized controlled trial.J Zhejiang Univ - Sci B. 2008; 9: 34-38
- Increasing perioperative communication with automated mobile phone messaging in total joint arthroplasty.J Arthroplasty. 2018; 33: 19-24
- Efficiency of text message contact on medical safety in outpatient surgery: retrospective study.JMIR mHealth and uHealth. 2020; 8: e14346
- The cost-effectiveness of smoking cessation support delivered by mobile phone text messaging: txt2stop.Eur J Health Econ. 2013; 14: 789-797
- Cost-effectiveness of a mobile-phone text messaging intervention on type 2 diabetes—a randomized-controlled trial.Health Policy Technol. 2020; 9: 79-85
- Top-of-License nursing practice. Jona.J Nurs Adm. 2018; 48: 266-271
- Describing nurses’ work: combining quantitative and qualitative analysis.Hum Factors: J Hum Factors Ergonomics Soc. 2006; 48: 5-14
- The nursing shortage and the future of nursing education is in our hands.J Nurs Educ. 2020; 59: 303-304
- WhatsApp and other messaging apps in medicine: opportunities and risks.Intern Emerg Med. 2020; 15: 171-173
- Reducing cancelations on the day of scheduled surgery at a children’s hospital.Pediatrics. 2015; 135: e1292-e1299
Article info
Publication history
Published online: April 12, 2022
Accepted:
April 6,
2022
Received in revised form:
April 5,
2022
Received:
February 12,
2022
Identification
Copyright
© 2022 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.