Recover@Home Postoperative Follow-up Study

Appendectomy, Hernia, Femoral, Hernia, Inguinal, Hernia, Umbilical, Hernia, Ventral, Testicular Hydrocele, Thyroidectomy, Varicocele

ambulatory surgery, nurse-led mobile health, postoperative care delivery, rural surgical facility, recovery at home, implementation science

This proposal describes a human subjects research study evaluating mHealth Ambulatory Surgery with Follow-up Nurse (Recovery@Home), as an alternative postoperative care pathway for selected low-acuity surgical procedures in Uganda. The Recovery@Home model discharges eligible patients home on the day of surgery and provides structured postoperative follow-up through nurse telephone calls, home visits, mobile-app documentation, escalation algorithms, and surgeon teleconsultation when clinically indicated. The proposed research includes a design to evaluate Recovery@Home against traditional postoperative inpatient care in a randomized controlled trial across three participating Ugandan surgical facilities.

Surgeries in high-income countries have progressively transitioned to ambulatory settings, but in low- and middle-income countries, even patients who have low-acuity surgeries still typically stay in the hospital after their surgeries, and these postoperative inpatient stays are costly and inefficient, for both patients and the surgical facilities. We propose an innovative approach of Recover@Home in Uganda, incorporating mobile technology into postoperative care, to ensure safe, cost-effective and efficient care with same-day discharge and reliable follow-up after surgery. Using a multicenter, randomized controlled trial, we will provide the evidence necessary to shift practice towards ambulatory surgery for low-acuity surgical procedures, resulting in more efficient and effective allocation of healthcare resources in LMICs.

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Uganda