REDUCING HOSPITAL LENGTH OF STAY FOR PATIENTS UNDERGOING MAJOR HEAD AND NECK SURGERY...47th Annual Oncology Nursing Society Congress, April 27–May 1, 2022, Anaheim, CA
During 2020, the Department of Otolaryngology was alerted by the Medical Institution that their patients had exceeded the expected hospital length of stay. The majority of these patients had undergone major head and neck surgery with the head and neck team at the associated NCI Comprehensive Cancer...
| Publicado en: | Oncology Nursing Forum Vol. 49; no. 2; pp. 10 - 12 |
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| Autor principal: | |
| Formato: | abstract proceedings research Journal Article |
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Oncology Nursing Society
Mar2022
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=155510818&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 155510818 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 0190535X 4F0 jtl: Oncology Nursing Forum issn: 0190535X maglogo: N pubinfo: dt: Mar2022 vid: 49 iid: 2 pid: 12496 pub: Oncology Nursing Society place: Pittsburgh, Pennsylvania artinfo: ui: 155510818 155510818 155510818 10.1188/22.ONF.E1 155510818 ppf: 10 ppct: 2 formats: fmt: @attributes: type: P tig: atl: REDUCING HOSPITAL LENGTH OF STAY FOR PATIENTS UNDERGOING MAJOR HEAD AND NECK SURGERY...47th Annual Oncology Nursing Society Congress, April 27–May 1, 2022, Anaheim, CA aug: au: Most, Allison affil: NYU Langone Health, New York, NY sug: subj: Head and Neck Neoplasms Surgery Length of Stay Early Patient Discharge Congresses and Conferences California California ab: During 2020, the Department of Otolaryngology was alerted by the Medical Institution that their patients had exceeded the expected hospital length of stay. The majority of these patients had undergone major head and neck surgery with the head and neck team at the associated NCI Comprehensive Cancer Center. Major head and neck surgery involves free flap reconstruction, transplantation of tissue to reconstruct areas of the upper aerodigestive tract surgically removed due to benign or malignant tumors. The Advanced Practice Providers (APP) spearheaded a quality improvement project to reduce the length of stay for patients scheduled to undergo major head and neck surgery. The intervention was an independent visit with the APP, separate from the surgical consult, to discuss with the patient and their support system a detailed surgical plan, day by day description of their inpatient stay, and expectations of wound care and care of tracheostomy tubes and feeding tubes. Based on this discussion, discharge planning would begin before the scheduled surgery. Second, medical clearance and cardiology clearance was reviewed by the APP and all comorbidities were added to the patient's problem list to accurately capture patient acuity. Third, the intervention included a preoperative visit with Speech Language Pathology (SLP) for assessment and education of speech and swallow expectations. Fourth, the intervention included evaluation of Thyroid Stimulating Hormone (TSH) to detect risk of poor wound healing and post-operative complications secondary to hypothyroidism. This information was communicated, visible, and accessible to the patient and their support system. It was also communicated to all involved inpatient teams. Last, a standard assessment protocol by inpatient Physical Therapy (PT) on post op day one was established as well as inpatient SLP on post day two. The quality improvement project was planned when the observed/expected length of stay was 1.13 in November 2020. Once the quality improvement project was initiated during January 2021, the observed/expected length of stay remained below 0.80 for the remainder of the year. The quality improvement project not only directly impacted a hospital metric, it resulted in improvement in coordination of care between outpatient and inpatient teams. Patient outcomes improved related to wound healing, mobility, speech and swallow, and discharge. Last, patients and their support system reported improved satisfaction of care during the perioperative time. pubtype: Academic Journal doctype: abstract proceedings research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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