Table 4.

Illustrative Quotes for Barriers Described by Clinicians

Health education

You educate the patient, you avoid a lot of postoperative communication problems or even the urgency to contact the physician. [Call center personnel, #07]

One more person might freak out about something that's totally normal and then other patients are like … think that it's normal, but it's actually a concern. And some people are more open to calling and asking and others aren't. [Nurse, #08]

Access to Team

It would be so nice if the patients could just call the office and talk to somebody. But they have to call the phone center. They still have to wait for a nurse to get paged, a nurse to call them back. [Surgeon, #01]

We're overbooked. We're seeing people at seven in the morning, seven at night. […] It's crazy. For us to get somebody in to check a wound, there's really not a ton of resources available to do it. [Surgeon, #06]

Healthcare practitioner time constraints

I did 10 laparotomies last week. […] So if I have some kind of an ongoing dialogue, electronic or otherwise, with all those patients, on a [inaudible] basis post discharge, I'm not going to be able to operate on 10 people this week. [Surgeon, #02]

It's a lot of work. It takes a lot of conscientious … because it's not built into the system. It's more us being very vigilant about things. [Surgeon, #05]

Care team experience and consistency

I have a dedicated nurse who has learned now what are the things to look for and understands what's involved. When it's not her that's there on a certain day, then I'm a little more worried and I have to be more involved when a patient calls in. [Surgeon, #05]

Early recognition [of] complications can actually make a huge difference in how we manage them and how the patients do in the end. And so when the practitioner doesn't know how to recognize that because they just don't have experience with it, I think that's a problem. [Surgeon, #05]