Same-Day Hospital Discharge Is Feasible for a Variety of Urologic Surgeries When Using a Virtual Hybrid Care Hotel.

Abstract

Introduction: To determine postoperative outcomes of same-day discharge to a patient Care Hotel after select urologic surgeries.

Methods: The Care Hotel is a hybrid-care model where patients, who historically would have been admitted, are discharged after surgery. In the Care Hotel, patients have access to an on-call nurse, paramedic team, and virtual access to the Command Center for medical questions or concerns. The primary outcome was 30-day hospital admission rates. Secondary outcomes included Clavien-Dindo complication rate, 48-hour Emergency Department (ED) visit, 30-day ED visit, and unplanned healthcare resource utilization. Other variables collected include demographics, American Society of Anesthesiologists class, procedure type, length of surgery, and patient calls while in the Care Hotel.

Results: Of 556 patients who underwent surgery from August 2021 to August 2023, most underwent holmium laser enucleation of the prostate (52%) and robotic-assisted radical prostatectomy (31%). Thirty-day admission rate was 2% and 30-day complication rate was 11%, with a Clavien-Dindo Grade 3 or higher complication rate of 0.2%. Thirty-day ED visit rate was 9%. Admissions, complications, and ED visits were not correlated with patient demographics, American Society of Anesthesiologists class, procedure type, or length of surgery. Three hundred patients (54%) did not make a single phone call to the Command Center.

Conclusions: Same-day discharge to the Care Hotel following certain urologic procedures was safe with favorable postoperative outcomes. Patients in the Care Hotel used fewer health resources compared with a hospital stay. The Care Hotel model is a feasible and effective alternative to hospital admission.