The Utility of Preoperative Phone Calls for Endoscopic Sinus Surgery Procedures

Objective Perioperative patient education improves patient satisfaction, surgical outcomes, and can reduce postoperative call volume. Here, we investigate whether the use of standardized preoperative phone calls elicits similar results in patients undergoing endoscopic sinus surgery (ESS). Methods Patients undergoing ESS at a tertiary rhinology center were identified prospectively through the electronic medical record (EMR). In the intervention cohort, a standardized preoperative educational phone call was performed. A postoperative survey was utilized to collect self-assessment of satisfaction and understanding in all patients. Postoperative call rates were obtained from the EMR. Wilcoxon rank sum and chi-squared analyses were conducted to compare results. Demographics of the otology and rhinology cohorts were compared with a Mann Whitney U-test. Results Data from 43 cases and 58 controls were collected. Patients receiving the intervention were similar to controls with regard to patient-reported understanding (case:9.1 ± 1.1 vs control:9.0 ± 1.4, p = 0.801) and satisfaction (case:9.4 ± 1.1 vs 8.9 ± 1.4, p = 0.155). Both cases and controls called the clinic regarding surgical outcomes more often than for postoperative medications or administrative concerns. Independent of receiving the intervention, patients that did not call clinic postoperatively had significantly better understanding of their procedures (call:8.6 ± 1.6 vs no-call:9.5 ± 1.0, p < 0.015) and satisfaction with their experience (call:8.8 ± 1.4 vs no-call:9.5 ± 1.1, p < 0.028). Patient age may contribute to lack of impact in the rhinology cohort, as compared to the otology group, but socioeconomic status does not seem to differentiate the two samples. Conclusion Though shown in other settings, a significant impact of educational phone calls prior to surgery was not observed in this sample. Patient education calls prior to endoscopic sinus surgery were not associated with changes in postoperative call volume to the clinic. Patient understanding and satisfaction may be related to other factors, such as patient selection or demographics. Future studies may target such patients prior to ESS.

Development of an employee call center for healthcare workers with symptoms and exposures to COVID-19

Coronavirus disease 2019 placed unprecedented challenges on the modern healthcare system. In addition to caring for patients directly affected by the virus, hospitals and clinics had to quickly mobilize forces in order to protect and manage employees with symptoms and/or exposures to COVID-19. Interventions are needed to efficiently diagnose and quarantine healthcare workers with disease while returning those without disease expediently in order to maintain a workforce capable of dealing with the pandemic surge. This article describes the Johns Hopkins system-wide occupational health response to the coronavirus outbreak. Specifically, the steps taken to develop and implement an employee covid call center that fielded 9,000 calls during the 2½ month initial surge of the virus are outlined. The 24/7 availability and rapid triage of healthcare workers led to an ultimate decline in call volume despite increasing exposure to the virus and rising hospitalizations.

Strategies to Handle Increased Demand in the COVID-19 Crisis a Corona Telephone Hotline and a Web-based Self-triage System

BackgroundIn emergencies, such as the COVID-19 pandemic, there is an increased need for contact withemergency medical services (EMS), and call volume might surpass capacity. Thus, the Copenhagen EMS in Denmark implemented a separate coronavirus hotline followed by a web-based self-triage system to reduce nonemergency call volume. The aim of this paper is to present the two measures implemented to handle the increased call volume to the Copenhagen EMSfromthose with mild or no relevant COVID-19 symptoms.MethodsThis is a cross sectional observational study monitoring call volume in the first month of the COVID-19 pandemic in accumulated callnumbers, compared to the equivalent numbers during one month from the year before (2019). A coronavirus hotline and web-based self-triage system arepresented in absolute numbers of users.ResultsIn the first month of the COVID-19 pandemic in Copenhagen, emergency medical dispatch centers were extensively overloaded with more than 10.800 calls, resulting in significantly prolonged queue time (mean time in minutes:12:02; CI: 11:55-12:09)) compared to 2019 (mean time in minutes02:23; CI: 02:22-02:25) and thereby limiting access to emergency assistance and triage for citizens. The introduction of the coronavirus hotline showed reduced call volume and queue time to the EMS. The web-based self-triage system was used more than 107.000 times. However, no correlation between call volume and the use of a web-based self-triage systemwas observed.ConclusionsCreating a coronavirus hotlinestaffed by healthcare personnelseemed to have an impact on call volume and potentially relieved the strain in resources, while the web-based self-triage system was widely used and could be further developed to reach itsfull potential. Other EMS organizations can implement these measures to enhance capacity in a future epidemic.