Abstract
Introduction
“No routine post-operative follow up appointments” policy has been implemented in NHS hospitals in different specialties for uncomplicated surgical procedures. In trauma and orthopaedics few studies to date reviewed this practice and reflected on the patients' opinions.
Methods
A total of 121 patients were recruited over 2 years, each patient had post operative follow up by the hand therapist for 3 months. 50 patients post Trapeziectomy and 71 patients post single digit Dupuytren's fasciectomy were prospectively surveyed for their opinion on their post operative care and whether they would have liked to be reviewed by the surgeon in a routine post operative follow up appointment or not. All operations were done by one surgeon in one hospital. All patients were reviewed by a hand therapist within 2 weeks post operatively and treatment protocols were followed with all the patients. During their final appointment with the hand therapist all patients completed a questionnaire.
Results
116 patients completed the study, 5 post Dupuytren's fasciectomy patients were lost for follow up. 106 patients (91%) were satisfied with their post operative management and 99 patients (85%) did not want to be reviewed by the surgeon in a post operative outpatient follow up appointment.
Discussion
This study reflects the successful application of “Hand therapy led follow up and discharge” policy with no routine post operative review by the surgeon. We succeeded in reducing the waste in the NHS by avoiding at least 215 un-necessary routine follow up appointments over a 2 year period. By applying this policy we also succeeded in avoiding the inconvenience to patients having multiple trips to the hospital. We advise implementing this practice for other common uncomplicated surgical procedures, with the possibility of giving the patient the option to request an appointment with the surgeon if needed.
