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| Name | Class |
|---|---|
| Virginia Tech Carilion School of Medicine and Research Institute | OTHER |
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The goal of this clinical trial is to learn if a patient-directed postoperative care program, using short educational videos, can improve patient satisfaction and reduce healthcare resource utilization in patients undergoing carpal tunnel release (CTR). The main questions it aims to answer are:
Will patients in the video-based care program be more satisfied with their postoperative care? Will this approach reduce healthcare resource use and the burden on patients without increasing complication rates? Researchers will compare the video-based patient-directed care group to the standard in-person follow-up group to see if patient satisfaction and resource use differ while maintaining similar outcomes and complication rates.
Participants will:
Watch three short educational videos (< 60 seconds each) on postoperative care. Schedule a suture removal appointment with a nurse at their convenience if needed.
Continue to have access to their provider through traditional methods such as phone, EMR, or urgent in-person visits.
Carpal tunnel release (CTR) is a commonly performed procedure with predictable outcomes and a low complication rate. Traditionally, patients are scheduled for two postoperative follow-up visits-one at two weeks and another at six weeks. However, these routine visits rarely lead to a change in patient management and often impose logistical and financial burdens on patients, particularly for those living in rural areas who must travel long distances to their healthcare provider's clinic.
This study proposes an alternative postoperative care model for CTR patients that leverages short educational videos and allows patients to manage their recovery more independently. The experimental group in the study will receive three brief (< 60 seconds each) educational videos after surgery. These videos will cover key aspects of postoperative care, including wound management and when to seek medical attention. Unlike the traditional model, patients in this group will not have scheduled in-person or virtual follow-up visits unless they require them. All patients in the experimental group will still have access to their healthcare provider through standard communication channels, such as:
Calling the office for advice or concerns. Sending secure messages through the electronic medical record (EMR) system. Attending urgent in-person visits if necessary. If nonabsorbable sutures are used during surgery, patients in the experimental group will schedule an appointment for suture removal with a nurse at their convenience, usually 10-14 days post-surgery.
The primary goal of the study is to determine whether this patient-directed care model, which utilizes educational videos, can improve patient satisfaction and reduce the use of healthcare resources without compromising care quality or increasing complication rates.
Specific Aim: The study aims to evaluate whether a patient-directed postoperative care program for CTR can:
Improve patient satisfaction. Reduce healthcare resource utilization. Lessen the burden of care (e.g., fewer missed workdays and less time spent on healthcare-related activities).
Maintain comparable patient-reported outcomes, complication rates, and the number of urgent visits as those observed in traditional in-person follow-up care.
Hypotheses:
Patients who receive the educational videos will report higher satisfaction with their care.
These patients will miss fewer days of work and spend less time on health-related activities.
The experimental group will consume fewer healthcare resources (e.g., fewer clinic visits).
Patient-reported outcomes, complication rates, and urgent visits will be similar between the experimental and standard in-person care groups.
Significance: The results of this study have the potential to transform and enhance postoperative care for patients undergoing CTR and other minor surgical procedures. By reducing the need for routine in-person visits, the proposed care model can help alleviate the burden on patients, particularly those from rural areas. Additionally, reducing clinic utilization for straightforward postoperative cases could increase the availability of clinic appointments for more complex cases, thereby improving overall healthcare system efficiency. This patient-directed model could also be expanded to other surgical and nonsurgical conditions, empowering patients to take a more active role in their recovery while maintaining high standards of care.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Standard of Care | No Intervention | In-person group will be followed with standard -of-care postoperative clinic visits with a hand & upper extremity orthopaedic surgeon at Carilion Clinic Institute for Orthopaedics and Neurosciences at 2 weeks and 6 weeks from date of service. | |
| Video Management | Experimental | Postoperative education will be provided with 3 short videos that will be accessible to patients on all social media platforms and through MyChart with no scheduled in person postoperative visits. Patients will have a one time visit with either nurse or orthopaedic technician for suture removal 10-14 days from surgery if the participant has nonabsorbable sutures placed during surgery. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Educational Videos | Other | Subjects in the experimental group will be provided with 3 links to videos to be watched after CTR surgery. These videos will be available through YouTube, Twitter, Facebook, Instagram, TikTok, or MyChart. Videos will be available to watch multiple times at the subjects choice. |
| Measure | Description | Time Frame |
|---|---|---|
| Patient-Reported Outcome Measurement Information System (PROMIS) / Upper Extremity Computer Adaptive Test (UE CAT) / 5-Point Likert Scale | All patient reported outcome measures will be reported at 2 and 6 weeks postoperatively. All responses will be recorded within the study's REDCap data base. | 2 and 6 weeks postoperatively |
| Measure | Description | Time Frame |
|---|---|---|
| Time Taken Off Work | Reported by patient or care giver during 2 and 6-week postoperative visits. (hours) | Baseline to 6 week follow up |
| Travel time. | Time spent traveling to attend postoperative care appointments. (hours) |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Cesar Bravo, M.D. | Carilion Clinic | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Carilion Clinic Orthopaedic Surgery | Roanoke | Virginia | 24014 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 33967640 | Background | Greenfield PT, Manz WJ, DeMaio EL, Duddleston SH, Xerogeanes JW, Scott Maughon T, Spencer CC, Dawes A, Boden SD, Hammond KE, Wagner ER, Gottschalk MB, Daly CA, Pombo MW. Telehealth Can Be Implemented Across a Musculoskeletal Service Line Without Compromising Patient Satisfaction. HSS J. 2021 Feb;17(1):36-45. doi: 10.1177/1556331620977171. Epub 2021 Feb 21. | |
| Background | https://www. pewresearch.org/internet/fact-sheet/social-media/?menuItem=81867c91- 92ad-45b8-a964-a2a894f873ef | ||
| 23091686 |
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| ID | Term |
|---|---|
| D002349 | Carpal Tunnel Syndrome |
| D017060 | Patient Satisfaction |
| ID | Term |
|---|---|
| D020423 | Median Neuropathy |
| D020422 | Mononeuropathies |
| D010523 | Peripheral Nervous System Diseases |
| D009468 | Neuromuscular Diseases |
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|
| Baseline to 6 week follow up |
| Number of Unplanned Visits | The number of visits that were not originally scheduled as a part of standard of care procedures. | Baseline to 6 week follow up. |
| Patient Satisfaction Questionnaire | Will record patient satisfaction as well as the number of unplanned visits, time taken off of work (hours), and travel time to attend appointments for postoperative care (hours). | Baseline to 6 week follow up. |
| Wound Complications | Electronic Medical Records review will be performed to determine: Number of wound complications. | Baseline to 6 week follow up. |
| Total In Person Postoperative Visits | Electronic Medical Records review will be performed to determine: Total number of in person postoperative visits | Baseline to 6 week follow up. |
| Background |
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| Background | https://www.pewresearch.org/internet/fact-sheet/mobile/ |
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| D009422 | Nervous System Diseases |
| D009408 | Nerve Compression Syndromes |
| D012090 | Cumulative Trauma Disorders |
| D013180 | Sprains and Strains |
| D014947 | Wounds and Injuries |
| D000074822 | Treatment Adherence and Compliance |
| D015438 | Health Behavior |
| D001519 | Behavior |