Why 

Surgical Site Infections (SSIs) are the leading cause of unplanned hospital readmissions and a primary factor in prolonged patient recovery. Research shows that most infections are only detected after the patient has left the hospital, resulting in critical opportunities for early intervention being missed. While traditional patient information provides generic advice, it lacks personalisation and offers no auditable way to track patient outcomes. This gap in post-discharge care can lead to more severe complications and higher costs for the Organisation.

What 

Implement PKB to support the 'Photo at Discharge' initiative and enable remote post-discharge wound monitoring.

To prevent surgical site related readmissions, implement follow-up questionnaires covering key symptoms, such as increased pain, redness, swelling, and discharge and track adherence to wound care instructions. 

The pathway ensures every patient leaves with clear verbal and written guidance, including who to contact if they have concerns or signs of wound infection.

How 

The process is simple, secure, and designed to support both patients and clinical teams throughout their postoperative recovery.

1. Photo at Discharge: Upon discharge, the nursing team take a baseline photograph of the surgical wound. This image, along with personalised wound and care advice, is securely shared with the patient through their PKB record.

2. Automated Remote Monitoring: After returning home, the patient automatically receives prompts on days 1, 3, and 7 to complete a short wound questionnaire and upload a new wound photo.

3. Centralised Clinical Review: All patient submissions are sent directly to a centralised Nurses Team for review. By comparing the new photos and symptom reports against the baseline discharge image, they can perform real-time surveillance and triage.

4. Timely Intervention: Based on their assessment, the clinical team can instantly reassure the patient if the wound is healing well, advise on care adjustments, or escalate for a clinical review if early signs of infection are detected.

How to Send an Image or Video in PKB

Watch this short video to see how quickly and easily patients can send an image or video in PKB.

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Key PKB Features 

Advanced Questionnaires 

Post op wound questionnaire examples 

• Bluebelle WHQ D30

• EQ5D

• Post-discharge questionnaire

Messaging

• Send and receive photos and messages securely. 

Example Post Operative Questionnaire

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Example SMART Goals 

1. Improve Early Detection of SSIs

Specific: Implement automated Post Op Photo Sharing with PKB questionnaire post-discharge on days 1, 3, and 7 for 100% of eligible surgical patients.
Measurable: Achieve a 90% completion rate for day-3 questionnaires within the first 6 months.
Achievable: Nursing staff verbal and written information and PKB automation.

Relevant: Early wound surveillance allows rapid triage and timely intervention, reducing preventable complications.
Time-bound: By the end of Q2 2026, reach the 90% adherence milestone.

2. Reduce Readmission Rates

Specific: Use PKB Messaging and questionnaires for remote monitoring to detect early wound complications and escalate promptly.
Measurable: Reduce surgical site infection-related readmissions by 20% compared to baseline (pre-PKB) within 12 months.
Achievable: Centralised nurse triage and reviews photos to make sure concerns are addressed before they escalate.
Relevant: Aligns with NHS Long Term Plan goals to reduce preventable readmissions.
Time-bound: Audit outcomes at 12 months post-implementation (Sept 2026).

3. Enhance Patient Engagement and Confidence

Specific: Provide every discharged patient with a baseline wound photo, personalised wound care plan, and clear contact pathway.
Measurable: Achieve 75% patient-reported confidence in knowing when and how to seek help (via survey at 2 weeks post-discharge).
Achievable: Standardised post-discharge pathway with information about the pathway given to patients on discharge. (Set up an automated pathway where integrations are in place. 

Relevant: Improves patient safety and shared decision-making.
Time-bound: Evaluate engagement scores at 6 months post-launch (March 2026).

4. Optimise Nursing Team Efficiency

Specific: Centralise review of photo and questionnaire submissions to reduce unnecessary outpatient visits and post op readmission.
Measurable: Reduce avoidable wound-related follow-up appointments by 25% within 9 months.
Achievable: Advanced Questionnaires sent to patients through automated. Nurse triage photos within 12 hours, allowing focus on patients with higher risk.
Relevant: Frees clinical capacity and enhances workforce productivity.
Time-bound: Measured at month 9 post-rollout (June 2026).

Pre-Metrics for a Team

Premetrics (baseline data points) are important so teams can measure the impact of the PKB pathway against what’s currently happening. Below are suggested premetrics for each SMART goal.

Early detection of surgical site infections

Metric 1: Current wound review contact rates

• What to measure: Percentage of patients currently contacted (by phone or clinic) within 7 days post-discharge for wound review.

• Why: Establishes baseline for comparison with PKB’s automated day 1, 3, 7 prompts.

• How: Audit discharge follow-up records and ward logbooks.

Metric 2: Average time to SSI detection

• What to measure: Median number of days post-discharge until SSI is identified.

• Why: Provides baseline for evaluating earlier detection with PKB photo/questionnaire monitoring.

• How: Retrospective chart review of patients with SSIs over the past x number of months.

Reducing SSI-related readmissions

Metric 3: Baseline readmission rates

• What to measure: Percentage of surgical patients readmitted within 30 days due to SSIs.

• Why: Core baseline to measure the impact of PKB pathway on reducing readmissions.
  How: Audit health records and readmission audits.

Metric 4: Cost of SSI-related readmissions

• What to measure: Average cost per SSI-related readmission episode.
  Why: Quantifies potential savings from preventing readmissions.

• How: Cost data.

Patient engagement and empowerment

Metric 5: Patient confidence in wound care

• What to measure: Percentage of patients who report high confidence in knowing how to care for their wound and when to seek help.

• Why: Provides baseline for measuring improvement in empowerment with PKB personalised plans.
  How: Short patient survey at 2 weeks post-discharge.

Nursing efficiency and workload

Metric 6: Current wound-related follow-up appointments

• What to measure: Average number of wound-related outpatient visits per x number of discharges.

• Why: Baseline for measuring reduction in unnecessary visits with PKB photo sharing.
  How: Outpatient clinic data audit.

Data quality and scalability

Metric 7: Documentation of wound healing journey

• What to measure: Percentage of patients with complete, structured wound monitoring documentation (baseline + follow-ups).

• Why: Establishes current limitations in auditable data.

• How: Review a random sample of patient records or staff survey.

Methodology for Collecting Pre-Metrics

• Data Audits: Review current PROMs collection methods, completion rates, and costs.

• Surveys: Short, targeted staff and patient surveys on current PROMs experience.

• Time Studies: Record time spent by staff on PROMs distribution, collection, and inputting.

These pre-metrics can be adapted to any service or specialty. Please contact your PKB Success Project Manager for support with tailoring PROMs implementation to your team.

Further Information

Transforming Post-Operative Follow-up: Mr Duffy, a Consultant in Trauma and Orthopaedics at Harrogate & District NHS Foundation Trust, harnesses the power of Digital Personalised Video messages with PKB.