Increased capture of post-endoscopic retrograde cholangiopancreatography adverse events by delayed (day 7) follow-up calls: a prospective comparison of physician- and nurse-initiated calls.

Abstract

Endoscopic retrograde cholangiopancreatography (ERCP) is a high-risk endoscopic procedure. We recently found that physician-initiated post-ERCP follow-up calls on day 7 post-ERCP increased adverse event capture. Subsequently, we prospectively evaluated the utility of nurse-initiated follow-up calls, comparing these with physician-initiated calls to assess the impact of transitioning this responsibility to a nurse.This prospective study was conducted on consecutive patients undergoing ERCP at our academic tertiary care medical center. Patients received phone calls on days 1 and 7 post-ERCP, from either an endoscopist or a nurse coordinator, using a standardized script to assess delayed complications (pancreatitis, non-pancreatitis abdominal pain, bleeding, infection, perforation), and unplanned health encounters.A total of 448 ERCP patients (239 physician calls, 209 nursing calls) were included. Physician calls were more successful than nursing calls in reaching patients on both day 1 (96% vs. 74%, P<0.001) and day 7 (91% vs. 63%, P<0.001). Nursing calls were significantly longer than physician calls on both days. A higher adverse event capture rate by physician calls compared to nursing calls was evident on day 1 (3.5% vs. 2.4%, P=0.04) and day 7 (10.6% vs. 6.3%, P=0.004). Physician follow-up calls on day 7 resulted in substantially more patients triaged to the Emergency Department, primary care and oncology clinics (P<0.001).Physician calls were significantly more effective than nurse calls in reaching patients, capturing adverse events, and triaging patients to appropriate care. These data support the value of physician-initiated calls, at least following the most complex procedures.

View details for DOI 10.20524/aog.2025.0970

View details for PubMedID 40697440

View details for PubMedCentralID PMC12277518