D54. Understanding Frustrations with Post-operative Drain Care and Identifying a Path for Improvement: A Mixed-methods Study

PURPOSE: Postoperative drains are used widely in plastic surgery (PS) and prevent several complications. Patients tasked with manual record-keeping of output and drain care at home experience increased anxiety. Providers also encounter frequent drain-related outpatient communication and inaccurate output measurements. METHODS: Single-institution data from the PS Clinical Advice Services (CAS) help line was investigated over six months. Providers were surveyed on the frequency and nature of drain-related outpatient communication, as well as their experiences related to drain care. Survey data was used to design a mobile application for electronic drain monitoring that facilitates drain care for patients and providers. RESULTS: Over six months, 163 patients contacted CAS 223 times. 15% of calls were drain-related. 74% were escalated to the on-call resident, compared to 10% for drain-unrelated calls. Providers perceived that 58% of calls were potentially preventable. Providers estimated that 25% of patients forget to bring manual drain logs to clinic and 21% of the time are concerned about inaccurate record-keeping. 90% of providers agree that an electronic system would resolve such issues. A mobile application was then created, featuring a patient-friendly interface for record-keeping and easy-to-interpret 24-hour measurements for providers planning drain removal. CONCLUSION: Post-operative drain care is challenging for both patients and providers, leading to excessive outpatient communication that is potentially preventable. Further data will determine if electronic drain monitoring improves provider and patient satisfaction.