Greater physician involvement could help reduce post-discharge surgical complications

January 12th, 2015

According to a new study in Archives of Surgery, more than 16% of patients experience at least one complication after general surgery in the hospital. More troubling is a second finding of the study: More than 40% of those complications occurred post-discharge.

The authors of the study conclude, somewhat obviously, that “Fastidious, procedure-specific patient triage at discharge as well as expedited patient follow-up could improve PD [post-discharge] outcomes.”

Well, sure. Everyone seems to agree the solution isn’t to keep patients in the hospital longer following surgery, potentially exposing them hospital-acquired infections and other risks.

But if patient follow-up is a big part of the solution, what kind of follow-up are we talking about, and who should perform it? Those are questions a lot of hospitals are wrestling with as they try their best to get 30-day readmissions down.

An NPR article about the study suggests that physicians must be involved in monitoring surgical patients post-discharge. According to the article, one of the study authors, a cancer surgeon, “changed how she practices … as a result of the research. She now makes sure her patients schedule a check-up appointment, either with her or with their primary care physicians, no later than 10 days after surgery. Sometimes she asks patients to email photos of their incision site, too.”

How involved are physicians at your hospital in reducing the frequency of post-discharge surgical complications?