Total Laryngectomy
Conditions
Brief summary
Patients undergoing total laryngectomy are at high risk for 30-day unplanned readmission. Many of these readmissions are related to stomal care, and it is thought that the readmissions could be prevented with better patient and caregiver education. The investigators are studying the effect of a comprehensive perioperative education program on 30-day unplanned readmission for patients undergoing total laryngectomy. The comprehensive perioperative education program will include the following additional interventions: -Preoperative visit with the speech pathologist for explanation of laryngectomy physiology, stomal education, and alaryngeal voice rehabilitation. Participants will be expected to undergo this intervention and to attend it with their laryngectomy coach (a family member or friend to accompany the patient through the education process), but failure to meet with the speech pathologist will not exclude a patient from the study. * Preoperative education class with a designated ENT laryngectomy nurse for patient and caregiver. The hands-on class introduces the patient and laryngectomy coach to the basics of stomal care. Participants and their laryngectomy coach will be expected to attend the preoperative education class * Printed laryngectomy journey guide given to patients at time of study enrollment for patient/caregiver. This journey guide details the preoperative, in-hospital, and post-discharge course and is provided as a reference throughout their journey. * Formalized, nursing administered practical evaluation of minimal competency of laryngectomy care for patient and caregiver/laryngectomy coach. This study will follow patients prospectively from the time of study commencement and then assess changes in patient knowledge before and after the education intervention. It will also compare rate of stomal complications and readmission rates to institutional historical averages to assess improvement in quality care.
Interventions
OTHERDemographics and Health History Questionnaire
OTHERPre-Class Laryngectomy Survey
BEHAVIORALCounseling session with speech pathologist
BEHAVIORALTotal Laryngectomy Preoperative Education Class
OTHERDay of Hospital Discharge Laryngectomy Survey
OTHERDay of Discharge Practicum
OTHERLaryngectomy Education Study Exit Survey
Sponsors
Washington University School of Medicine
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
SUPPORTIVE_CARE
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* planned total laryngectomy at Barnes Jewish Hospital * age 18 or older * understand spoken or written English language * able to provide informed consent.
Exclusion criteria
-none
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Rate of 30-day unplanned readmission | 30 days after hospital discharge (approximately 7 weeks after registration) | -Calculate and report the rates of readmission for the patients undergoing the comprehensive laryngectomy education and compare to the rates of unplanned readmission and postoperative complications from historical cohorts at our institution. |
| Rate of postoperative complications | 30 days after hospital discharge (approximately 7 weeks after registration) | -Calculate and report the rates of readmission for the patients undergoing the comprehensive laryngectomy education and compare to the rates of unplanned readmission and postoperative complications from historical cohorts at our institution. |
| Change in patient's knowledge about total laryngectomy | 30 days after hospital discharge (approximately 7 weeks after registration) | -The change in knowledge due to the educational intervention will be measured using a within subject comparison of patient pre- and post-education test scores (e.g. each patient's post-education scores minus preeducation scores). |
Countries
United States
Outcome results
None listed