Follow-up of children who undergo an uncomplicated surgical procedure: A caregiver survey to determine satisfaction, family impact, and preferences for alternate follow-up.

ABSTRACT

BACKGROUND: Historically most surgical patients returned to clinic for an in-person postoperative follow-up. However, returning to hospital impacts the family in many ways. We hypothesized that in-person follow-up is not necessary after an uncomplicated procedure, and that caregivers would prefer an alternate follow-up. METHODS: We surveyed caregivers of children less than 17 years of age who underwent a simple appendectomy, pyloromyotomy, cholecystectomy, or repair of an inguinal or umbilical hernia. With REB approval and caregiver consent, surveys were completed in-person during clinic visits and by telephone for alternate follow-up plans. RESULTS: Despite interruptions due to COVID-19, 24 surveys were completed (clinic visit group N = 7, alternate plan group N = 17). Thirteen families resided in Winnipeg. The majority rated their overall satisfaction with follow-up as good-excellent (6/7 clinic group, 17/17 alternate group). The most frequent impacts to attend clinic were time off work (18/24), parking (17/24), gas costs (17/24), time from school (13/24) and childcare arrangements (12/24). The median estimated cost to attend clinic was 142 CAD$. Most families preferred an alternate plan (18/24) (i.e. call surgeon only if concerned, follow-up with their primary care provider or attend virtually). Only 4 children having an alternate follow-up plan required medical treatment for minor issues. DISCUSSION: We conclude there is significant impact on families to attend a post-operative in-person clinic visit. Although all respondents rated their satisfaction highly, the majority preferred the option of an alternate plan. Surgeons should consider offering families alternate follow-up after an uncomplicated procedure.