Patient Experience with Virtual Preoperative Consultations in Pediatric Surgical Specialties

Rebecca A Netson; Stephanie Miller; Joseph Incorvia; Ankoor Shah; Carlos R Estrada Jr; Sara L Toomey; Amir H Taghinia

doi:10.1016/j.jpedsurg.2022.12.027

Patient Experience with Virtual Preoperative Consultations in Pediatric Surgical Specialties

J Pediatr Surg. 2023 Sep;58(9):1776-1782. doi: 10.1016/j.jpedsurg.2022.12.027. Epub 2022 Dec 28.

Authors

Rebecca A Netson¹, Stephanie Miller¹, Joseph Incorvia¹, Ankoor Shah², Carlos R Estrada Jr³, Sara L Toomey⁴, Amir H Taghinia⁵

Affiliations

¹ Department of Plastic and Oral Surgery, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, United States.
² Department of Ophthalmology, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, United States; Harvard Medical School, 25 Shattuck Street, Boston, MA, United States.
³ Department of Urology, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, United States; Harvard Medical School, 25 Shattuck Street, Boston, MA, United States.
⁴ Department of Pediatrics, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, United States; Harvard Medical School, 25 Shattuck Street, Boston, MA, United States.
⁵ Department of Pediatrics, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, United States; Harvard Medical School, 25 Shattuck Street, Boston, MA, United States. Electronic address: amir.taghinia@childrens.harvard.edu.

PMID: 36690572
DOI: 10.1016/j.jpedsurg.2022.12.027

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: IP; IP/VV; Patient satisfaction; Pediatric surgery; Press ganey survey; Telemedicine; VV; Virtual visits.

MeSH terms

COVID-19* / epidemiology
Child
Cross-Sectional Studies
Humans
Male
Pandemics
Patient Outcome Assessment
Patient Satisfaction
Referral and Consultation
Telemedicine*
Urology*