Discharge Planning, Laparoscopy
Conditions
Keywords
Bariatric surgery, Laparoscopic surgery, Abdominal abscesses, Liver abscesses, Discharge planning
Brief summary
The investigators are conducting a prospective study to evaluate the SKH@Home programme, a post-discharge monitoring initiative for surgical patients. The aim of this study is to conduct a pragmatic, non-randomized pilot study to compare the SKH@Home programme with standard post-surgical care on patient outcomes.
Interventions
PROCEDUREEarly post-surgical discharge with post-surgical home based monitoring
The SKH@home program, is a post-discharge monitoring program, which allows stable post-surgical patients to be discharged earlier from hospital while providing regular post-discharge monitoring at the patient's own home, either through home visits and patient assessment, or telemonitoring of patients.
PROCEDUREStandard inpatient care until deemed suitable for discharge
Patients will receive standard postoperative management in the acute hospital until they are deemed fit for discharge by their primary surgeon
Sponsors
Sengkang General Hospital
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
21 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. Patient is keen for home management 2. Hemodynamically stable 3. Able and willing to self-care and monitor / Good social support 4. Lives in Singapore's Northeast region EITHER 5. Diagnosed with intra-abdominal abscess requiring ongoing IV antibiotics as recommended by Infectious Diseases Specialist where necessary OR Diagnosed with liver abscess requiring ongoing IV antibiotics as recommended by Infectious Diseases Specialist where necessary AND Has undergone initial treatment (e.g., drainage if required) and is clinically improving OR 6. Underwent an uneventful straightforward bariatric surgical procedure, and has been monitored overnight without any immediate postoperative issues OR Underwent uneventful straightforward laparoscopic/ endoscopic/ minimally invasive surgery, and has been monitored for at least 6 hours without any immediate postoperative issues AND has no significant intraprocedural concerns by the operating surgeon
Exclusion criteria
1. Unable to self-care / no caregiver 2. Requires daily review by the surgical team 3. Suspicion of surgical complications requiring surgical intervention 4. Requires post-discharge monitoring care for \> 2 weeks 5. Unregulated psychiatric disorders 6. Daily flushing of drains required
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Bed days saved | From enrollment to 30 days after patient is discharged from the hospital/ post-discharge monitoring programme | Bed days saved in the acute hospital setting |
| Return to hospital | From enrollment until 30-days after patient is discharged from the hospital/ from post-discharge monitoring care | Unplanned readmission/ return to the hospital within 30-days |
| Length of stay | From enrollment until patient is discharged from the hospital/ from post-discharge monitoring care (up to around 2 weeks), whichever is longer | Combined length of stay. For inpatients, will be time of admission till time of discharge from acute hospital For patients enrolled into post-discharge monitoring programme, will be from time of admission till time of discharge from post-discharge monitoring programme |
| Hospitalisation bill | From enrollment until 30-days after patient is discharged from the hospital/ from post-discharge monitoring care | Total non-subsidised hospitalisation bill size |
| Postoperative complications | From enrollment until 30-days after patient is discharged from the hospital/ from post-discharge monitoring care | 30-day postoperative complications, graded by the Clavien-Dindo classification |
Contacts
Primary ContactChui Kwan Mok
Outcome results
None listed