The efficiency of quick response code versus telephone contact for post-discharge follow-up after ophthalmic day surgery: a randomized controlled trial.

PURPOSE: To assess and compare the efficiency of quick response (QR) code versus telephone contact for post-discharge follow-up in patients receiving low-risk ophthalmic day surgery. METHODS: One hundred and sixty patients undergoing strabismus day-care surgery with general anesthesia were randomly allocated to either the intervention group using QR code (QR group) or the control group receiving telephone call (TEL group) for post-discharge follow-up. The primary outcome was the follow-up overall attendance rate on the second postoperative day. Secondary outcomes included attendance rate at the first scheduled follow-up, number of text message reminders, elapsed time and estimated cost for follow-up, omission rate of follow-up responses, and patient satisfaction. RESULTS: The overall attendance rate of follow-up was significantly higher in the QR group than that in the TEL group (97.5% vs. 87.5%, p = 0.016). As compared with the TEL group, the QR group significantly reduced the number of text message reminders with higher attendances at the first scheduled follow-up (p < 0.001, p = 0.001). Besides, the TEL group cost a median time of 258 s and a median cost of RMB 5.8 yuan to complete a follow-up consultant, but was associated with a significantly high omission rate of follow-up responses comparing to the QR group (p = 0.002). Patient satisfaction was comparable between two groups. CONCLUSION: QR code follow-up can be more efficient than traditional telephone contact in assessing the post-discharge recovery after strabismus day surgery, which provides a safe and intuitively alternative follow-up pathway for identifying issues that may necessitate further clinical care for more low-risk ophthalmic day surgeries.

Using Clinical-Based Discharge Criteria to Discharge Patients After Ophthalmic Ambulatory Surgery Under General Anesthesia: An Observational Study.

PURPOSE: To verify the feasibility of the clinical-based discharge (CBD) criteria and identify the reasons of long postanesthesia care unit length of stay (PACU-LOS) for ophthalmic ambulatory surgical patients under general anesthesia. DESIGN: A prospectively observational study conducted at a tertiary eye center in China. METHODS: Medical records were collected from patients admitted for strabismus ambulatory surgery under general anesthesia from September 2018 to March 2019. The patients were discharged home once met the CBD criteria based on a combination of the modified Aldrete's scoring system and Chung's Post-Anesthetic Discharge Scoring System. Postoperative complications were recorded in the PACU and within 24 hours after discharge. Multivariate logistic regression was applied to identify the factors relating to late discharges. FINDINGS: All patients (N = 400) were safely and successfully same-day discharged home as none of the patients informed severe emergency events or unanticipated readmission. Nine displayed discharge delays mainly because of mild postoperative nausea and vomiting (PONV) although met the discharge criteria. About 85.5% of patients were discharged within a PACU-LOS of 150 minutes, 379 (94.8%) were within 180 minutes, and the cutoff time in PACU-LOS was 150 minutes. Multivariable analysis indicated that sevoflurane anesthesia and the presence of PONV were related to late discharges (PACU-LOS of greater than 150 minutes, all P < .05). CONCLUSIONS: The CBD criteria can efficiently and safely guide the ophthalmic ambulatory surgical patients to discharge home on the same-surgery day, whereas sevoflurane anesthesia and the presence of PONV are associated with a relatively long PACU-LOS.