Katherine Gallagher
Introduction
Post-operative anaesthetic follow-up after day-case surgery is essential for detecting complications and assessing recovery. Traditional models relying on patient-initiated contact and routine telephone calls are labour-intensive and may fail to reliably reach patients. With rising day-case surgeries, scalable and
efficient solutions are needed. We evaluated an SMS-based follow-up survey integrated within an existing patient portal and electronic patient record to improve access, efficiency, and patient engagement.
Methods
A prospective quality improvement project introduced an automated SMS survey at 24 hours post-surgery, with responses accepted to 72 hours and a reminder at 48 hours. The survey assessed symptoms and recovery, with a predefined escalation threshold (>40) triggering clinician telephone review. Outcomes
included patient engagement, escalation rates, and clinician workload.
Results
228 surveys were sent over two weeks, with 139 responses (61%). No responses triggered clinician-initiated follow-up, with one high score appropriately excluded due to inpatient admission. Most patients reported no (21.3%), mild (39.6%) or moderate (32.5%) pain; 6.5% reported severe pain, with 92.4% finding analgesia
effective. Functional pain assessment showed 89.9% patients reported no breathing difficulties, 9.4% mild, and 0.7% severe, indicating minimal functional limitation from pain. Patient feedback was highly positive, highlighting satisfaction with care with minor themes of pre-operative information gaps.
Conclusions
SMS-based follow-up provides a safe, scalable alternative to telephone review, enabling reliable patient contact without increasing workload. Integration within existing digital infrastructure supports rapid implementation. Outcomes were comparable to national benchmarks and align with national priorities to increase day surgery capacity through modern, efficient & standardised pathways.
Authors
Katherine Gallagher, Sade Okutubo, Vaibhav Nagar
Homerton Healthcare NHS Foundation Trust, London, United Kingdom