Abstract
Introduction
For the past 3 years, our institution has implemented a same clinic-day surgery (CDS) program, where common surgical procedures are performed the same day as the initial clinic evaluation. We sought to evaluate the patient and faculty/staff satisfaction following the implementation of this program.
Methods
After IRB approval, patients presenting for the CDS between 2014 and 2017 were retrospectively reviewed. Of these, patient families who received CDS were contacted to perform a telephone survey focusing on their overall satisfaction and to obtain feedback. In addition, feedback from faculty/staff members directly involved in the program was obtained to determine barriers and satisfaction with the program.
Results
Twenty-nine patients received CDS, with the most commonly performed procedures being inguinal hernia repair (34%) and umbilical hernia repair (24%). Twenty (69%) patients agreed to perform the telephone survey. Parents were overall satisfied with the CDS program, agreeing that the instructions were easy to understand. Overall, 79% of parents indicated that it decreased overall stress/anxiety, with 75% saying it allowed for less time away from work, and 95% agreeing to pursue CDS again if offered. The most common negative feedback was an unspecified operative start time (15%). While faculty/staff members agreed the program was patient-centered, there were concerns over low enrollment and surgeon continuity, because there were different evaluating and operating surgeons.
Conclusion
This study successfully evaluated the satisfaction of patients and faculty/staff members after implementing a clinic-day surgery program. Our results demonstrated improved patient family satisfaction, with families reporting decreased anxiety and less time away from work. Despite this, faculty and staff members reported challenges with enrollment and surgeon continuity.
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Abbreviations
- PCP:
-
Primary care provider
- CDS:
-
Clinic-day surgery
- QI:
-
Quality improvement
- OR:
-
Operative room
- NPO:
-
Nil per os
- URI:
-
Upper respiratory infection.
References
Alkhoury F, Burnweit C, Malvezzi L et al (2012) A prospective study of safety and satisfaction with same-day discharge after laparoscopic appendectomy for acute appendicitis. J Pediatr Surg 47(2):313–316
Aguayo P, Alemayehu H, Desai AA, Fraser JD, St Peter SD (2014) Initial experience with same day discharge after laparoscopic appendectomy for nonperforated appendicitis. J Surg Res 190(1):93–97
Cairo SB, Raval MV, Browne M, Meyers H, Rothstein DH (2017) Association of same-day discharge with hospital readmission after appendectomy in pediatric patients. JAMA Surg 152:1106–1112
Dexter F, Epstein RH, Dexter EU, Lubarsky DA, Sun EC (2017) Hospitals with briefer than average lengths of stays for common surgical procedures do not have greater odds of either re-admission or use of short-term care facilities. Anaesth Intensive Care 45(2):210–219
Gronnier C, Desbeaux A, Piessen G et al (2014) Day-case versus inpatient laparoscopic fundoplication: outcomes, quality of life and cost-analysis. Surg Endosc 28(7):2159–2166
Molina JC, Misariu AM, Nicolau I et al (2018) Same day discharge for benign laparoscopic hiatal surgery: a feasibility analysis. Surg Endosc 32(2):937–944. https://doi.org/10.1007/s00464-017-5769-5
Scrimin S, Haynes M, Altoe G, Bornstein MH, Axia G (2009) Anxiety and stress in mothers and fathers in the 24 h after their child’s surgery. Child Care Health Dev 35(2):227–233
Singletary D (2016) Evaluation of the safety and efficacy of same-day discharge following outpatient surgery in a US hospital. Nurs Manag (Harrow, Lond, Engl: 1994). 23(4):34–38
Pomicino L, Maccacari E, Buchini S (2018) Levels of anxiety in parents in the 24 h before and after their child’s surgery: a descriptive study. J Clin Nurs 27(1–2):278–287. https://doi.org/10.1111/jocn.13895
Lozada MJ, Nguyen JT, Abouleish A, Prough D, Przkora R (2016) Patient preference for the pre-anesthesia evaluation: telephone versus in-office assessment. J Clin Anesth 31:145–148
Olson JK, Deming LA, King DR et al (2017) Single visit surgery for pediatric ambulatory surgical procedures: a satisfaction and cost analysis. J Pediatr Surg 53(1):81–85. https://doi.org/10.1016/j.jpedsurg.2017.10.021
Horan TC, Gaynes RP, Martone WJ, Jarvis WR, Emori TG (1992) CDC definitions of nosocomial surgical site infections, 1992: a modification of CDC definitions of surgical wound infections. Infect Control Hosp Epidemiol 13(10):606–608
Ravikumar TS, Sharma C, Marini C et al (2010) A validated value-based model to improve hospital-wide perioperative outcomes: adaptability to combined medical/surgical inpatient cohorts. Ann Surg 252(3):486–496 (discussion 496–488).
Tagge EP, Hebra A, Overdyk F et al (1999) One-stop surgery: evolving approach to pediatric outpatient surgery. J Pediatr Surg 34(1):129–132
Barnett SJ, Frischer JS, Gaskey JA, Ryckman FC, von Allmen D (2012) Pediatric hernia repair: 1-stop shopping. J Pediatr Surg 47(1):213–216
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
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A waiver of informed consent was obtained through the IRB process.
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Criss, C.N., Brown, J., Gish, J.S. et al. Clinic-day surgery for children: a patient and staff perspective. Pediatr Surg Int 34, 755–761 (2018). https://doi.org/10.1007/s00383-018-4288-3
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DOI: https://doi.org/10.1007/s00383-018-4288-3