Telehealth as an effective method of follow-up for pediatric post tonsillectomy patients

• Published in: American journal of otolaryngology Vol. 43; no. 6; p. 103639
• Main Authors: Smith, Alyssa J., Yoon, Jenny J., Cofer, Shelagh A., Orvidas, Laura J.
• Format: Journal Article
• Language: English
• Published: Maryland Heights Elsevier Inc 01-11-2022; Elsevier Limited
• Subjects: Adenotonsillectomy; Appointments & personnel changes; Caregivers; Communication; Comorbidity; Complications; Demographics; Down syndrome; Dysphagia; Emergency medical care; Health care facilities; Nausea; Nurses; Otolaryngology; Pain; Patients; Pediatric otolaryngology; Pediatrics; Postoperative; Quality improvement; Response rates; Surgery; Telehealth; Telemedicine; Tonsillectomy; Quality improvement; Adenotonsillectomy; Pediatric otolaryngology; Telehealth; Tonsillectomy
• ISSN: 0196-0709; 1532-818X
• DOI: 10.1016/j.amjoto.2022.103639

To determine if pediatric patients can be safely and effectively managed postoperatively with nurse led telehealth communication.
This is a retrospective case series conducted at a tertiary academic medical center pediatric otolaryngology practice. Retrospective chart review was conducted on patients <18 years old who underwent tonsillectomy from January 2017 to December 2019. Patients were managed postoperatively with a telehealth communication on postoperative day (POD) 3–5 and again at 4–6 weeks. Patient demographics, satisfaction with follow-up, number of office visits, and postoperative complications were recorded.
829 tonsillectomy patients were identified. Average patient age was 5.7 years (range 10 months-16 years). Successful contact was made with the patient's caregiver on POD 3–5 for 511 patients. 322 patients successfully completed 4–6 weeks telehealth follow-up. 292 patients (91 %) reported improvement in pre-operative symptoms at 4–6 weeks. Overall, 98 % of patients who completed telehealth follow-up were satisfied with this method and did not desire an additional office appointment. 62 patients (21 %) participated in an office follow-up in 2017, 54 patients in 2018 (19 %), and 36 patients (14 %) in 2019. Only 61 of these visits were routinely scheduled postoperative tonsillectomy office visits. 53 patients (6 %) had a postoperative tonsillectomy bleed and 31 patients (4 %) required return to the operating room for cauterization.
Telehealth is successful in reducing the number of post-tonsillectomy office visits for pediatric patients without a subsequent increase in complications. Reduction in office visits can lead to cost reduction and increased availability of pediatric otolaryngology appointments.