A Consultation Phone Service for Patients With Total Joint Arthroplasty May Reduce Unnecessary Emergency Department Visits

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http://hdl.handle.net/10138/300991

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Hällfors , E , Saku , S A , Mäkinen , T J & Madanat , R 2018 , ' A Consultation Phone Service for Patients With Total Joint Arthroplasty May Reduce Unnecessary Emergency Department Visits ' , Journal of Arthroplasty , vol. 33 , no. 3 , pp. 650-654 . https://doi.org/10.1016/j.arth.2017.10.040

Title: A Consultation Phone Service for Patients With Total Joint Arthroplasty May Reduce Unnecessary Emergency Department Visits
Author: Hällfors, Eerik; Saku, Sami A.; Mäkinen, Tatu J.; Madanat, Rami
Contributor: University of Helsinki, Clinicum
University of Helsinki, I kirurgian klinikka (Töölö)
Date: 2018-03
Language: eng
Number of pages: 5
Belongs to series: Journal of Arthroplasty
ISSN: 0883-5403
URI: http://hdl.handle.net/10138/300991
Abstract: Background: Different measures for reducing costs after total joint arthroplasty (TJA) have gained attention lately. At our institution, a free-of-charge consultation phone service was initiated that targeted patients with TJA. This service aimed at reducing unnecessary emergency department (ED) visits and, thus, potentially improving the cost-effectiveness of TJAs. To our knowledge, a similar consultation service had not been described previously. We aimed at examining the rates and reasons for early postdischarge phone calls and evaluating the efficacy of this consultation service. Methods: During a 2-month period, we gathered information on every call received by the consultation phone service from patients with TJAs within 90 days of the index TJA procedure. Patients were followed for 2weeks aftermaking a call to detectmajor complications and self-initiated EDvisits. Datawere collected fromelectronic medical charts regarding age, gender, type of surgery, date of discharge, and length of hospital stay. Results: We analyzed 288 phone calls. Calls were mostly related to medication (41%), wound complications (17%), and mobilization issues (15%). Most calls were resolved in the phone consultation. Few patients (13%) required further evaluation in the ED. The consultation service failed to detect the need for an ED visit in 2 cases (0.7%) that required further care. Conclusion: The consultation phone service clearly benefitted patients with TJAs. The service reduced the number of unnecessary ED visits and functioned well in detecting patients who required further care. Most postoperative concernswere related to prescribed medications, wound complications, and mobilization issues. (c) 2017 Elsevier Inc. All rights reserved.
Subject: consultation phone service
total joint arthroplasty
complications
total knee arthroplasty
total hip arthroplasty
TOTAL KNEE ARTHROPLASTY
TOTAL HIP-ARTHROPLASTY
ENHANCED RECOVERY
READMISSION
LENGTH
RATES
STAY
PAIN
3126 Surgery, anesthesiology, intensive care, radiology
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