Page 83 - Poster Sessions] CUA 2022 Annual Meeting Abstracts

P. 83

2022 CUA ABSTRACTS

CUA 2022 Annual Meeting Abstracts – Poster Session 11:

EDI, COVID, Patient Relations

Sunday, June 26, 2022 • 07:30–09:00

Cite as: Can Urol Assoc J 2022;16(6Suppl1):S105-10. http://dx.doi.org/10.5489/cuaj.7933

MP-11.1 MP-11.5
Evaluation the outcome of urological phone consultation during Quality improvement of surgical team communication of required
COVID-19 pandemic percutaneous nephrolithotomy equipment
1
1
1
1
Waleed Shabana , Neda Ghaffari-Marandi , Emmanuel Kawa , Mohammed Mark Assmus , Matt Lee , Jessica Helon , Amy Krambeck 1
1
1
1
Bassuony , Ahmed Kotb , Hazem Elmansy , Walid Shahrour 1 1 Department of Urology, Northwestern University, Chicago, IL, United
1
1
1 Northern Ontario School of Medicine, Thunder Bay, ON, Canada States
Introduction: We aimed to assess patient satisfaction of conver- Introduction: Percutaneous nephrolithotomy (PCNL) allows for a range of
sion to phone consultation in urology clinic during the COVID- instruments within the urologist’s armamentarium. Case-to-case variation
10 pandemic, and to investigate potential patient complaints creates challenges within the operating room. Appropriate communica-
that could be handled as phone consultations in the future. tion can help ensure safe, efficient, and cost-effective patient care. The
Methods: We conducted a retrospective review for new urological tele- goal of our study was to first perform a quality assessment of equipment
consultations between April 2020 and September 2020 at our institute. A communication. Second, we identified and assessed a target intervention
telephone interview was conducted with potential participants who were to improve communication and surgical case cost.
invited to answer a designed questionnaire. The questionnaire included nine Methods: We administered 45 prospective (30 baseline, 15 post-interven-
questions covering patient satisfaction, quality of educational information, tion) questionnaires to multidisciplinary endourology members involved in
confidentiality, ability to share sensitive information, efficacy in absence of ≥3 PCNL cases between August 1, 2021, and October 30, 2021. The pri-
physical examination, overall acceptance, and preference of future telecon- mary objective was postoperative perception of communication regarding
sultation regarding time and cost saving. Patients’ responses were scaled equipment (Likert scale: 1-poor, 10-perfect). A real-time, editable equipment
using a five-point Likert scale (1=strongly disagree to 5=strongly agree). whiteboard was designed and implemented with post-intervention provider
Results: After screening and assessment, 770 of 864 (89.1%) patients surveys. The relative difference in pre- and post-intervention equipment
fulfilled the inclusion criteria; 94 (10.9%) were excluded due to hearing accuracy, as well as overall case costing, was compared 30 days prior to
impairment or age under 18. Forty-two (5.5%) refused to participate, 310 implementation to the period after the intervention. Comparisons used
(40.3%) of the patients could not be reached by phone, and eventually 307 Fisher’s exact test (p<0.05).
(39.9%) completed the questionnaire. The highest percentage of agreement Results: Baseline surveys (n=30) were completed (15 registered nurses,
(94.4%) was among those who felt consultation was private and confiden- eight resident physicians, five surgical techs, two fellows) with an average
tial. The lowest agreement was found in the question relating to the ability 2.6 years (range <1–7 years) of PCNL experience. Pre- and postopera-
of the physician to do the job without physical exam (72.3%). A total of 204 tive assessment of communication improved after implementation of the
(66.4%) patients agreed to future teleconsultation regarding time and cost whiteboard (preoperative: 6.7 vs. 8.9, p<0.001; postoperative: 7.0 vs. 9.3,
savings (Table 1). On multivariate analysis, irritative lower urinary symptoms p<0.001). On average, 3.2 items (range 2–5) out of five items were accur-
was the only independent factor associate with high degree of satisfaction ate on pre-intervention cases. Post-intervention accuracy improved to 4.4
(p=0.02) and wish for future teleconsultation (p=0.03). (3–5)/5 items (p=0.049). There was a significant relative case cost improve-
Conclusions: Urological teleconsultation is a feasible option during travel ment after implementing the whiteboard, with an average of $292.50 USD
restrictions, as during COVID-19 pandemic. Two-thirds of patients agree savings per case (p=0.045).
to future teleconsultation. For one-third of patients, the inability to perform Conclusions: The development of a real-time, editable PCNL equipment
physical examinations is a concern. whiteboard improved team perception of equipment communication, case
MP-11.1. Table 1. Participants’ response to questionnaire
Extremely disagree Disagree Neutral Agree Extremely agree
n (%) n (%) n (%) n (%) n (%)
Q1: Ability to express concerns 2 (0.7) 5 (1.6) 27 (8.8) 107 (34.9) 164 (53.4)
Q2: Quality of teleconsultation 2 (0.7) 10 (3.3) 22 (7.2) 106 (34.5) 166 (54.1)
Q3: Timing and efficacy 3 (1.0) 2 (0.7) 18 (5.9) 78 (25.4) 206 (67.1)
Q4: Confidentiality 0 (0.0) 1 (0.3) 14 (4.6) 60 (19.5) 230 (74.9)
Q5: Ability to share sensitive information 0 (0.0) 6 (2.0) 17 (5.5) 65 (21.2) 219 (71.3)
Q6: Quality of education 1 (0.3) 9 (2.9) 33 (10.7) 86 (28.0) 178 (58.0)
Q7: Degree of overall satisfaction 2 (0.7) 9 (2.9) 26 (8.5) 87 (28.3) 183 (59.6)
Q8: Ability to conduct teleconsultation without 6 (2.0) 19 (6.2) 58 (18.9) 104 (33.9) 118 (38.4)
physical examination
Q9: Preference of future teleconsultation 16 (5.2) 27 (8.8) 58 (18.9) 79 (25.7) 125 (40.7)
regarding cost and distance

78 79 80 81 82 83 84 85 86 87 88