Active Telephonic Follow-up During COVID-19 Lockdown: Initial Experience
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Active Telephonic Follow-up During COVID-19 Lockdown: Initial Experience
Communication on phone can be an effective option for consultation during follow-up [4]. In the present study, we received good response both from the parents and the locally available doctors. Even in this era of telecommunication, with a lot of people having a mobile phone, surprisingly none of the patients with problems contacted us. This may be because patients do not feel comfortable in contacting the treating doctor on phone, and probably need to be proactively informed about the availability of this mode for problem resolution.
The severe acute respiratory syndrome coronavirus-2 (SARSCoV-2) pandemic forced a lockdown in India in late March, 2020. Prior to this, our department was working normally with 30-35 pediatric surgeries per week. As the lockdown was announced, a lot of patients who were discharged recently were lost to follow-up in the immediate post-operative period. We herein present our initial experience with telephonic follow-up and management of these children.
Most parents informed that initially the local general practitioners, when contacted, were not willing to handle these patients due to the notion of complication in a post-operative child and apparent lack of skills to treat them. With telephonic contact with the local general practitioners, we were able to manage 6 out of 9 complications (66.6%) with their help. Though there are chances of miscommunication on phone and difficulty in interpretation of all the instruction, one can avoid it if standard operating procedures are developed and followed diligently [5].
We prospectively collected the details of telephonic follow-of pediatric surgical patients discharged in the preceding two weeks period (10-24 March, 2020) before the nationwide lockdown. Data of children with day-care procedures was not collected. Parents of children eligible for study were called on the mobile numbers provided at the time of admission. In case of failure to contact, it was decided to stop calling after three days of twice daily calls. The problems identified, advice given and the outcome were recorded.
We propose from our experience that in wake of any event affecting the movement of patients, active efforts and call from the treating doctors can make a lot of difference with minimal effort and energy. Recent guidelines on telemedicine will go a long way in strengthening this model of patient care [6].
A total of 32 children were discharged during this period, out of which 26 families (81.2%) could be contacted. Of these, 10 (38.5%) had already paid a visit in the postoperative period and did not require any intervention, whereas the remaining had not visited since discharge and were not under follow-up. Seven children (26.9%) fared well in the post-operative period and were advised stitch removal from local health center. Nine (34.6% of contactable patients) parents had complaints viz, ostomy diarrhea with dehydration in three neonates (responded well to intravenous fluid administra
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