Medical outcomes are hard to track
Many outcomes monitoring projects rely upon the day surgery staff to call patients one to two days following surgery to record reports of pain, nausea, infection, or other complications. However, this is not always the best way to identify postoperative complications, says Annie Meeks, BSN, administrator of Mountain View Surgery Center in Loveland, CO.
"Our involvement with patients is narrowly focused on the day of surgery and maybe the day after surgery," she says. "If the patient reports complications to his or her physician or ends up in an emergency department in another city, we never hear about it," she adds.
To address this gap, Meeks developed a physician reporting tool that is mailed to each surgeon on a monthly basis. (See Patient Outcome Reporting tool enclosed in this issue.) The letter goes out on the 15th of each month to ask surgeons about patients on whom they operated the previous month. A list of the physician’s patients is attached, and the physician is asked to place a code by each patient who experienced a complication.
"We know the physician will see the patient one to two weeks after surgery for a follow-up visit, and we know the patient will contact the physician if there are complications before that visit," explains Meeks.
The medical advisory board for the surgery center made completion of these monthly surveys a requirement for re-appointment to staff, she says. Not surprisingly, Meeks receives 90 to 100% return on the surveys.
Meeks also sends a satisfaction survey to patients. (See Post Operative Questionnaire enclosed in this issue.) If patients indicate a less than satisfactory experience, Meeks personally calls the patient to find out how the experience could have been improved.
Results from the surveys are presented to physicians and staff members at regularly scheduled meetings. "It is important that everyone involved in collecting the information know what is happening after patients leave our center and how those patients view our service," Meeks explains.
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