Redesigning Pre-surgery Patient Journeys With Telehealth
概览
- 阶段
- 不适用
- 干预措施
- 未指定
- 疾病 / 适应症
- Surgery
- 发起方
- KK Women's and Children's Hospital
- 入组人数
- 258
- 试验地点
- 1
- 主要终点
- Proportion of eligible elective surgery patients assessed successfully via telehealth for preoperative evaluation
- 状态
- 进行中（未招募）
- 最后更新
- 去年
概览
简要总结
Prior to surgery, patients undergo preanaesthesia assessment to ensure timely optimisation of medical conditions that could adversely impact perioperative outcomes. At the Preadmission Service (PAS) clinic of KK hospital, nurses perform the first triage to identify patients who require outpatient anaesthetic review in advance of surgery. While all elective patients attend the PAS clinic, only 8% are require outpatient anaesthetic review. The majority 92%, can be safely triaged to receive preanaesthesia assessment on the day of surgery. In this project, the investigators propose to investigate the efficacy of a new pre-surgery workflow for elective surgical patients incorporating telehealth. The investigators hypothesize that the redesigned pre-surgery journey incorporating telehealth reduces in-person consultation at the pre-admission clinic by up to 90%. Primary outcome is the proportion of eligible same-day-admission patients assessed via telehealth. Secondary outcomes are:
- Patient cost and time savings
- Patient experience of the new model of care
- Staff experience of the new workflow
- Incidence of day-of-surgery cancellations
详细描述
Prior to elective surgery, patients undergo preanaesthesia assessment to ensure timely optimisation of medical conditions that could adversely impact perioperative outcomes. Preadmission Service (PAS) clinic nurses at KK Hospital perform pre-surgery triage to identify patients requiring outpatient anaesthetic review. PAS data shows that only 8% of same-day-admission (SDA) patients needed an anaesthetist's review; the majority (92%) can be safely triaged to receive preanaesthesia assessment on the day of surgery. The aim of this study is to investigate the service re-design, efficacy and effectiveness of a new telehealth pre-surgery model of care for elective SDA patients. The investigators hypothesize that the telehealth pre-surgery new model of care will achieve an expected 50% uptake for SDA patients as the primary outcome during implementation. Secondary outcomes are patient cost savings, patient experience of the new model of care, and staff experience of the new workflow. The investigators will use a sequential exploratory mixed methods study design, consistent with the 5-stage model for telehealth research. An implementation science framework - the Normalisation Process Theory, underpins our 3-phase study. Phase 1 (service redesign) explores the feasibility of presrugery telehealth via semi-structured interviews of patients and healthcare staff. Phase 2 (preimplementation) investigates efficacy of the telehealth model of care by addressing service fidelity, and patient and staff experience using administrative data. Phase 3 is a pragmatic trial to ascertain effectiveness of the telehealthmodel of care, addressing the primary and secondary outcomes stated. This novel study using implementation science to redesign and implement presurgery telehealth will inform scale-up, spread, and sustainability of a new model of care within SingHealth and other health clusters in Singapore.
研究者
入排标准
入选标准
- •Patient participants:
- •Age 21 to 70 years Listed for elective surgery English literacy Willing to provide signed consent Of any nationality Able to give own legal consent
排除标准
- •Healthcare participants:
- •Age 21 to 70 years Healthcare professionals comprising clinic staff (surgical outpatient clinics, PAS), clinicians (anaesthetists, surgeons), and health service managers)
结局指标
主要结局
Proportion of eligible elective surgery patients assessed successfully via telehealth for preoperative evaluation
时间窗: One year from the initiation of the implementation phase (Phase 3)
Of the total number of patients booked for elective surgery, the proportion of patients evaluated preoperatively by telehealth is measured.
次要结局
- Healthcare providers' perception and attitude towards a Telehealth model of care for preoperative evaluation(5 months from July to November 2021)
- Patient's perception and attitude towards a Telehealth model of care for preoperative evaluation(5 months from July to November 2021)