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J Gastrointest Surg. 2017 Nov;21(11):1865-1878. doi: 10.1007/s11605-017-3573-0. Epub 2017 Sep 20.

Ready to Go Home? Patients' Experiences of the Discharge Process in an Enhanced Recovery After Surgery (ERAS) Program for Colorectal Surgery.

Author information

1
Department of Surgery, Mount Sinai Hospital, Toronto, ON, Canada.
2
Department of Surgery, University of Toronto, Toronto, ON, Canada.
3
Zane Cohen Clinical Research Unit, Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, ON, Canada.
4
Department of Surgery, Mount Sinai Hospital, Toronto, ON, Canada. robin.mcleod@cancercare.on.ca.
5
Department of Surgery, University of Toronto, Toronto, ON, Canada. robin.mcleod@cancercare.on.ca.
6
Zane Cohen Clinical Research Unit, Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, ON, Canada. robin.mcleod@cancercare.on.ca.
7
Institute of Health Policy Management, University of Toronto, Toronto, ON, Canada. robin.mcleod@cancercare.on.ca.
8
Cancer Care Ontario, 16th floor, 620 University Ave, Toronto, ON, M5G 1L7, Canada. robin.mcleod@cancercare.on.ca.

Abstract

BACKGROUND:

With the adoption of enhanced recovery after surgery (ERAS) programs, patients are being discharged earlier and require more post-discharge teaching, educational materials, and information.

OBJECTIVE:

The purpose of this study is to assess satisfaction, discharge needs, and follow-up concerns of patients within an ERAS implementation program (iERAS).

METHODS:

Between 2012 and 2015, the iERAS program was undertaken at an academic hospital where 554 patients having elective colorectal surgery were enrolled. After discharge, patients were sent a survey containing multiple choice questions, preference ranking, and open-ended questions. Free-text responses were analyzed through a thematic approach.

RESULTS:

Overall, 496 patients were mailed surveys and 219 (44.2%) completed the survey. Ninety-three percent were satisfied with the discharge information, and 90% felt they were ready for discharge. Eighty-six percent of patients saw their surgeon at 6 weeks, and 88% were satisfied with this follow-up plan. Some patients felt they had inadequate post-operative information, including how to resolve complications while at home and lack of reliable information for common post-operative occurrences. Patients with ostomies wanted more information about what to expect post-discharge and what symptoms were normal. Support from the homecare team and having a surgical nurse available were considered to be essential.

CONCLUSIONS:

Improved post-operative education for surgical patients prior to discharge within iERAS is required to facilitate patient-centered discharge planning. Such interventions may help decrease unplanned hospital visits during the immediate post-discharge period.

KEYWORDS:

Barriers/facilitators; Discharge planning and follow-up; Enhanced recovery after surgery (ERAS); Patient experience

PMID:
28932946
DOI:
10.1007/s11605-017-3573-0
[Indexed for MEDLINE]

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