Reducing Length of Stay in Reconstructive Head and Neck Surgery Patients: A Quality Improvement Initiative.

IF 2.6 3区医学 Q1 OTORHINOLARYNGOLOGY

Otolaryngology- Head and Neck Surgery Pub Date : 2024-08-09 DOI:10.1002/ohn.933

Nupur Bhatt, Jackie Yang, Lauren DeBaere, Ronald Shen Wang, Allison Most, Yan Zhang, Elan Dayanov, Wenqing Yang, Michele Santacatterina, Maria Kamberi, Jacqueline Mojica, Emily Kamen, Justin Savitski, John Stein, Adam Jacobson

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引用次数: 0

Abstract

Objective: To investigate whether a new preoperative education and discharge planning protocol reduced unexpected discharge delays for patients undergoing reconstructive surgery for head and neck cancer.

Methods: A quality improvement (QI) intervention was implemented in January 2021 with several components to address historically prolonged observed lengths of stay (LOS) with head and neck cancer patients. The intervention added a preoperative educational visit with a head and neck cancer advanced practice provider, a standardized preoperative speech and swallow assessment, a personalized patient care plan document, discussion of inpatient hospital stay expectations, and early discharge planning. The intervention group included patients who underwent the preoperative education protocol from February to December 2021. For comparison, an age and sex-matched control group was constructed from inpatients who had been admitted for similar procedures in the 2 years prior to the QI intervention (2019-2020) and received standard of care counseling.

Results: Our study demonstrated a significant reduction in observed to expected LOS ratio after implementation of the intervention (1.24 ± 0.74 control, 0.95 ± 0.52 intervention; P = .012).

Discussion: We discuss a preoperative education QI intervention at our institution. Our findings demonstrate that our intervention was associated with decreased LOS for patients undergoing head and neck reconstructive surgeries.

Implications for practice: This QI study shows the benefit of a new standardized preoperative education and discharge planning protocol for patients undergoing head and neck reconstructive surgeries.

查看原文本刊更多论文

缩短头颈部整形手术患者的住院时间：质量改进计划。

目的研究新的术前教育和出院计划方案是否能减少头颈部癌症整形手术患者的出院延迟：2021 年 1 月实施了一项质量改进（QI）干预措施，该措施包含多项内容，旨在解决头颈部癌症患者住院时间（LOS）过长的历史遗留问题。干预措施增加了头颈癌高级医疗服务提供者的术前教育访问、标准化术前言语和吞咽评估、个性化患者护理计划文件、住院预期讨论以及早期出院规划。干预组包括 2021 年 2 月至 12 月期间接受术前教育方案的患者。为了进行比较，我们还从质量创新干预前两年（2019-2020 年）因类似手术入院并接受标准护理咨询的住院患者中选取了年龄和性别匹配的对照组：我们的研究表明，实施干预后，观察到的住院日与预期住院日之比明显降低（对照组为 1.24 ± 0.74，干预组为 0.95 ± 0.52；P = .012）：讨论：我们讨论了本机构的一项术前教育 QI 干预措施。讨论：我们讨论了本院的一项术前教育 QI 干预措施，研究结果表明，我们的干预措施与头颈部整形手术患者 LOS 的减少有关：这项 QI 研究表明，新的标准化术前教育和出院计划方案可为头颈部整形手术患者带来益处。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Otolaryngology- Head and Neck Surgery 医学-耳鼻喉科学

CiteScore

6.70

自引率

2.90%

发文量

250

审稿时长

2-4 weeks

期刊介绍： Otolaryngology–Head and Neck Surgery (OTO-HNS) is the official peer-reviewed publication of the American Academy of Otolaryngology–Head and Neck Surgery Foundation. The mission of Otolaryngology–Head and Neck Surgery is to publish contemporary, ethical, clinically relevant information in otolaryngology, head and neck surgery (ear, nose, throat, head, and neck disorders) that can be used by otolaryngologists, clinicians, scientists, and specialists to improve patient care and public health.