Outcomes of a Virtual Medicine Hybrid Model for Postoperative Care Following Mastectomy and Immediate Tissue Expander Breast Reconstruction: A Retrospective Review.

Abstract

Introduction: The Care Hotel is a virtual medicine hybrid model of care implemented at the Mayo Clinic to increase use of enhanced recovery protocols, address hospital capacity and reduce medical costs. This voluntary accommodation offers patients a comfortable environment to receive nursing care postoperatively with in-person daytime monitoring and 24-hour virtual telemonitoring in a hotel setting. This study aims to evaluate postoperative outcomes in patients admitted to the Care Hotel after mastectomy with immediate tissue expander reconstruction compared to standard overnight admission.

Methods: A retrospective review of the electronic medical record was conducted for patients who underwent mastectomy with immediate tissue expander reconstruction prior to (1/2019-1/2020) and after (7/2021-7/2023) the implementation of the Care Hotel. Postoperative outcomes, including 48-hour ED visit, 48-hour readmission, and 30-day infection, hematoma, seroma, admission, and return to operating room were collected.

Results: There were 61 patients with 108 tissue expander reconstructions in the hospital admission group and 122 patients with 212 tissue expander reconstructions in the Care Hotel group. The average length of hospital stay was 1.2 days while the average Care Hotel stay was 1.4 days. There were four 48-hour ED visits with 1 admission for 12 hours of observation in the Care Hotel group. There was no statistically significant difference in 30-day infection, seroma, hematoma, readmission, need for IR drain procedure or return to operating room between the groups.

Conclusions: This investigation demonstrates the safety of postoperative virtual telemonitoring and should encourage providers to utilize virtual visit technology in the immediate postoperative time-period.