Improving postoperative outcomes in gynecologic oncology through a standardized telehealth intervention: experience from an urban safety-net hospital system.

OBJECTIVE

To evaluate the impact of a standardized postoperative phone call program on outcomes among patients undergoing gynecologic oncology surgery at an urban safety-net tertiary care center.

METHODS

As a quality improvement initiative, routine postoperative calls were implemented in January 2025 for all surgical patients on the gynecologic oncology service at our center. Nursing staff contacted patients 48-72 h after discharge using a structured questionnaire. We conducted a retrospective cohort study of patients who underwent surgery in the 4 months before and after implementation (9/1/2024-4/30/2025). Data were collected via chart review. Primary outcomes were readmission and mortality within 90 days. Secondary outcomes included ED visits, postoperative visit attendance, and outpatient complication management.

RESULTS

Among 466 patients, 215 received phone calls and 251 did not. Baseline characteristics were similar. Patients receiving calls had higher postoperative visit attendance (94.4% vs. 86.9%, p = 0.006) and more outpatient management of complications (18.1% vs. 6.7%, p < 0.001). ED visits and readmission rates were similar between groups; however, repeat readmissions were lower among contacted patients (mean 1.9 vs. 2.4, p = 0.042). Of those contacted, 41.4% reported concerns, most commonly nonspecific symptoms, pain, and constipation. Mortality was 1.4% in the phone call group vs. 4.4% among those who were not called (p = 0.059).

CONCLUSIONS

Standardized postoperative phone calls improved follow-up adherence and outpatient complication management, suggesting enhanced care coordination.