Timing of Perioperative Surgeon-Family Communication: a Randomized Controlled Trial

Introduction: Perioperative communication is important in reducing family member anxiety and improving their overall experience. With a focus on patient and family centered care, we aimed to determine the effect of strategic communication with patients’ relatives during the perioperative period on their satisfaction, anxiety and overall experience.

Methods: All English-speaking patients undergoing Orthopaedic procedures who were >18 y.o and accompanied by an adult were included. Enrolled patients were randomly assigned to a communication pathway. In the control group, the surgeon communicated with the family near the completion of the procedure. In the intervention group, families received additional standardized electronic updates via pagers at three pivotal moments: 1) Initial skin incision has been made, 2) Critical part of the case is complete and 3) Closure is complete. Surgeons communicated the final update near the end of the procedure, followed by the post-operative survey.

Results: 82 surveys were completed. Overall family satisfaction and anxiety did not differ significantly between the groups (p=1.00; p=0.091). Satisfaction with the number of updates was significantly higher in the intervention pathway (p=0.001). Most subjects in both groups wanted updates when the patient enters the OR (53.2%), the critical part of the case is complete (73.4%), closure is complete (73.4%), and when the patient leaves the OR (67.1%).

Conclusion: The overall level of satisfaction and anxiety of the family members was independent of the frequency of intraoperative surgical updates. However, family members receiving additional updates were more satisfied with the number of updates received. Family members exhibited a desire for updates at additional critical time points. The results of this study indicate that family updates during strategic time-points, such as when the surgery is about to begin and when the wound is closed, is preferred by a majority of patient families.