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Patient experience with virtual preoperative consultations in pediatric surgical specialties

Published:December 27, 2022DOI:https://doi.org/10.1016/j.jpedsurg.2022.12.027

      Highlights

      • What is current known about this topic?
      • Rise in telehealth adoption during COVID-19 highlights need for pediatric care adaptability.
      • What new information is contained in this article?
      • Telehealth pediatric pre-op evaluations non-inferiority to in-person, per patient experience scores and access.

      Abstract

      Background

      A cross-sectional study was conducted to assess the comparative effectiveness of virtual visits for preoperative evaluation and surgical decision-making in three pediatric surgical subspecialties.

      Methods

      Patients who underwent surgical procedures in the departments of Urology, Ophthalmology, and Plastic and Oral Surgery at a tertiary care pediatric hospital over a one-year period during the COVID-19 pandemic were included. Patients were assigned to one of three clinical pathways based on their preoperative visit(s): only in-person visit(s) (IP), a combination of in-person and virtual visit(s) (IP/VV), and only virtual visit(s) (VV). Demographics, procedure information, and patient experience survey results were collected. We then assessed variations in procedure types and patient experience scores in these three patient groups.

      Results

      There were 431 patients who completed the modified patient experience survey. The most common procedures were circumcision (17%), excision of lesion (16%), and strabismus repair (11%). Survey results were positive, with 90% of participants rating that they would recommend the service to others. No significant differences were found among groups in their demographics, overall care rating, and duration between preoperative clinic visit and procedure. Post-hoc power analysis indicated 87% power to detect a 10% difference in survey ratings between IP and VV cases, confirming non-inferiority in patient satisfaction for virtual preoperative visits.

      Conclusion

      This study demonstrated the non-inferiority of preoperative virtual visits in three pediatric surgical subspecialties as measured by patient experience scores. Additional studies with more granular scope are necessary to further elucidate telemedicine's safety and efficacy for select diagnoses.

      Level of evidence

      III.

      Keywords

      Abbreviations:

      A. PGAS (Press Ganey Ambulatory Surgery Survey), B. IP (In person Visit), C. IP/VV (In Person and Virtual), D. VV (Virtual)
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