(0244) Predictors and Themes of Perioperative Patient Initiated Communications in Endoscopic Sinus Surgery: Opportunities to Improve

Introduction: Effective perioperative communication is critical for patient education and expectation management. We aim to identify the prevalence of and reasons for patient-initiated communications (PIC) in the perioperative period for outpatient endoscopic sinus surgery.

Methods: This study was a retrospective chart review. Records were obtained for patients who underwent outpatient endoscopic sinus surgery with and without concomitant procedures from January 1, 2023 through December 31, 2023. Patient demographics, surgical characteristics, frequency of PIC, and reasons for perioperative PIC were recorded. Average number of pre, post, and total perioperative communications as well as the likelihood of engaging in PIC were compared between patient and surgical characteristics. Two reviewers identified prevalent themes among the documented reasons for PIC. Themes were consistently revised to be more inclusive as more data was acquired until thematic saturation was reached.

Results: A total of 149 PIC were recorded among 98 patients. The majority of patients were male (51%), 82 (84%) underwent primary surgery, 32 (33%) had a history of smoking, and 29 (30%) had a history of anxiety/depression. The number of PIC and overall likelihood of engaging in PIC was not significantly influenced by gender (OR: 1.22, 95% CI [0.53,2.8]) or smoking history (OR: 1.80; 95% CI [0.71,4.7]). Patients who received a nasal septal splint intraoperatively were significantly more likely to engage in PIC (OR: 2.59; 95% CI [1.08,6.23]) as were patients with a history of anxiety/depression (OR: 11.9; 95% CI [4.0,35]. The most common reasons for preoperative PIC included scheduling concerns and recovery information. The most common reasons for postoperative PIC included nasal obstruction and epistaxis.

Conclusions: Perioperative PIC is common among patients undergoing outpatient endoscopic sinus surgery. Identifying motives for these communications and patient populations who have a higher incidence of PIC may guide quality improvement initiatives to preemptively address these concerns and ultimately decrease the number of PIC.