Hostname: page-component-cd9895bd7-7cvxr Total loading time: 0 Render date: 2024-12-26T08:39:34.816Z Has data issue: false hasContentIssue false
  • English
  • Français

Digital solution for follow-up in congenital cardiac surgery

Published online by Cambridge University Press:  09 September 2021

Laura Carlson Open the ORCID record for Laura Carlson [Opens in a new window] ,
Jacqueline O’Brien ,
Nitin Gujral ,
Vincent Chiang ,
Pedro del Nido  and
Meena Nathan
Laura Carlson
Affiliation:
Department of Cardiac Surgery, Boston Children’s Hospital, Boston, MA, USA Boston Children’s Hospital, Boston, MA, USA
Jacqueline O’Brien
Affiliation:
Department of Cardiac Surgery, Boston Children’s Hospital, Boston, MA, USA Boston Children’s Hospital, Boston, MA, USA
Nitin Gujral
Affiliation:
Boston Children’s Hospital, Boston, MA, USA Innovation Acceleration Program, Boston Children’s Hospital, Boston, MA, USA
Vincent Chiang
Affiliation:
Boston Children’s Hospital, Boston, MA, USA Department of Emergency Medicine, Boston Children’s Hospital, Boston, MA, USA Harvard Medical School, Boston, MA, USA
Pedro del Nido
Affiliation:
Department of Cardiac Surgery, Boston Children’s Hospital, Boston, MA, USA Boston Children’s Hospital, Boston, MA, USA Harvard Medical School, Boston, MA, USA
Meena Nathan*
Affiliation:
Department of Cardiac Surgery, Boston Children’s Hospital, Boston, MA, USA Boston Children’s Hospital, Boston, MA, USA Harvard Medical School, Boston, MA, USA
*
Author for correspondence: M. Nathan, MD, MPH, Department of Cardiac Surgery, Children’s Hospital Boston, 300 Longwood Ave, Bader 273, Boston, MA 02215, USA Tel: (617) 355 7932; Fax: (617) 730 0214. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

In this era of public scrutiny, there is an ongoing need for innovative methods for patient follow-up.

Objectives:

As part of a quality initiative, we developed an automated post-operative follow-up system for patients following discharge after cardiac surgery at Boston Children’s Hospital.

Methods:

Discharge Communication (DisCo) is a web-based system developed at Boston Children’s Hospital. An automated text and e-mail with a link to a health status survey are sent at 30 days and 1 year post-discharge in English/Spanish. If there is no response, surveys are completed via phone calls to the patient/patient’s physician or chart review. Responses are stored in the DisCo database and the patient’s medical record. Patients who underwent cardiac surgery and survived to hospital discharge from October, 2016 received the surveys.

Results:

Overall, 3345 30-day and 2563 1-year surveys were sent between October, 2016 and June, 2020. Of 3345 30-day surveys, there were 3191 responses (95%). Of 2563 1-year surveys, there were 1807 responses (71%). Most patients/families responded directly to the link at 30 days (65% for paediatrics/75% for adults) and at 1 year (72% for paediatrics/78% for adults). Multi-variable logistic regression revealed that higher complexity of cardiac lesion, presence of major non-cardiac anomalies and presence of major residua were associated with readmission and catheter/surgical reinterventions. Non-cardiac anomalies were associated with increased need for services for learning, development or behaviour.

Conclusions:

DisCo provides a successful web-based health status assessment of patients following congenital cardiac surgery. It helps to identify high-risk patients who need closer follow-up.

Keywords

Follow-upcongenital cardiac surgeryelectronic communication
Type
Original Article
Information
Cardiology in the Young , Volume 32 , Issue 7 , July 2022 , pp. 1032 - 1040
Check for updates
Copyright
© The Author(s), 2021. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Meeting Presentations: Electronic poster presentation at the Southern Thoracic Surgical Association 66th Annual Meeting, Marco Island, November 2019.

References

Kane, LC. After congenital heart surgery. the patient guide to heart, lung, and esophageal surgery. Retrieved June 2018, from https://ctsurgerypatients.org/before-during-and-after-surgery/after-congenital-heart-surgery.Google Scholar
O’Brien, SM, Clarke, DR, Jacobs, JP, et al. An empirically based tool for analyzing mortality associated with congenital heart surgery. J Thorac Cardiovasc Surg 2009; 138: 1139–1153.10.1016/j.jtcvs.2009.03.071CrossRefGoogle ScholarPubMed
Nathan, M, Karamichalis, J. Quality improvement: surgical performance. Technical performance score as a performance measure for congenital heart surgery. In: Sellke/Sabiston and Spencer’s Surgery of the Chest, 9th edn., 2015, p. Chapter–134.Google Scholar
Nathan, M, Karamichalis, JM, Colan, S, et al. Surgical technical performance scores are predictors for late mortality and unplanned reinterventions in infants after cardiac surgery. J Thorac Cardiovasc Surg 2012; 144: 1095–1101.10.1016/j.jtcvs.2012.07.081CrossRefGoogle ScholarPubMed
Nathan, M, Karamichalis, J, Liu, H, et al. Technical performance scores are strongly associated with early mortality, postoperative adverse events and ICU length of stay – analysis of consecutive discharges over 2 years. J Thorac Cardiovasc Surg 2014; 147: 389–396.10.1016/j.jtcvs.2013.07.044CrossRefGoogle Scholar
Ubeda Tikkanen, A, Nathan, M, Sleeper, LA, et al. Predictors of postoperative rehabilitation therapy following congenital heart surgery. J Am Heart Assoc 2018; 7: e008094.10.1161/JAHA.117.008094CrossRefGoogle ScholarPubMed
Kauw, D, Koole, MAC, Winter, MM, et al. Advantages of mobile health in the management of adult patients with congenital heart disease. Int. J. Med. Inform 2019; 132: 104011.10.1016/j.ijmedinf.2019.104011CrossRefGoogle ScholarPubMed
Higgins, J, Semple, J, Murnaghan, L, Sharpe, S, Theodoropoulos, J. Mobile web-based follow-up for postoperative ACL reconstruction: a single-center experience. Orthop J Sports Med 2017; 5: 232596711774527.10.1177/2325967117745278CrossRefGoogle ScholarPubMed
Avery, KNL, Richards, HS, Portal, A, et al. Developing a real-time electronic symptom monitoring system for patients after discharge following cancer-related surgery. BMC Cancer 2019; 19: 244.10.1186/s12885-019-5657-6CrossRefGoogle ScholarPubMed
Litt, JS, Agni, M, Jacobi-Polishook, T, et al. The acceptability and feasibility of emailed parent questionnaires for medical and developmental surveillance after NICU discharge. J Perinatol 2017; 38: 392–401.10.1038/s41372-017-0022-6CrossRefGoogle ScholarPubMed
Pronk, Y, Pilot, P, Brinkman, JM, van Heerwaarden, RJ, van der Weegen, W. Response rate and costs for automated patient-reported outcomes collection alone compared to combined automated and manual collection. JPRO 2019; 3: 113.Google ScholarPubMed
Kinnula, S, Renko, M, Tapiainen, T, Pokka, T, Uhari, M. Post-discharge follow-up of hospital-associated infections in paediatric patients with conventional questionnaires and electronic surveillance. J Hosp Infect 2012; 80: 13–16.10.1016/j.jhin.2011.09.005CrossRefGoogle ScholarPubMed