Postoperative Care After Carpal Tunnel Release Using Short Educational Videos

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.

Inclusion criteria

• Patients undergoing either endoscopic (CPT 29848) or open CTR (CPT 64721)
• Access to a smartphone, tablet, or computer to view educational videos
• Access to internet to download or view postoperative education videos
• Age 18 or older

Exclusion criteria

• Patients undergoing any additional procedures
• Worker's compensation status
• Revision procedures
• Patients unable to utilize technology to view videos or follow instructions
• Patients with no access to internet
• Inability to provide informed consent for the study
• Patients unable to speak English fluently