Satisfaction with same-day discharge after laparoscopic appendectomy for non-perforated appendicitis
Presenter Status
Fellow
Abstract Type
QI
Primary Mentor
Tolulope Oyetunji
Start Date
8-5-2023 11:30 AM
End Date
8-5-2023 1:30 PM
Presentation Type
Poster-Restricted Access
Description
Problem Statement/Question: Our current practice is to discharge patients with non-perforated appendicitis the same day after laparoscopic appendectomy. However, caregivers might be apprehensive or anxious about being discharged from the hospital right after their child’s surgery.
Background/Project Intent (Aim Statement): Same-day discharge (SDD) after laparoscopic appendectomy for acute non-perforated appendicitis is safe, without an increased rate of postoperative complications, emergency department visits, or re-admissions. We aimed to evaluate caregiver satisfaction with this protocol.
Methods (include PDSA cycles): Patients discharged on the day of laparoscopic appendectomy for non-perforated acute appendicitis were identified between January 2022-August 2022. Surveys to evaluate satisfaction with the protocol were distributed to the caregivers via e-mail or text message 96 hours after discharge. Telephone surveys were conducted if there were no responses to the initial online survey. The surveys assessed comfort with SDD, post-operative pain control adequacy, post-operative provider contact, and overall satisfaction. The protocol focused on avoidance of narcotics in the postoperative period and immediate return to a regular diet.
Results: A total of 255 cases of non-perforated acute appendicitis underwent SDD. The survey response rate was 50.6% (n=129). Most respondents were Caucasian (69.0%, n=89) and male (51.9%, n=67), with a median age of 12.0 years (IQR 8.9,14.7). The median postoperative length of hospital stay was 3.8 hours (IQR 3.2,4.8). The overall satisfaction rate was 91.5%, with 118 caregivers feeling satisfied with SDD. Most caregivers felt comfortable with the SDD protocol (89.9%, n=116), with 22.5% (n=29) calling a medical provider postoperatively. Approximately nine out of ten caregivers reported that pain was adequately controlled (91.5%, n=118). In contrast, those that were dissatisfied reported issues with pain control and anxiety with SDD after a surgical procedure.
Conclusions: Caregiver satisfaction and comfort with same-day discharge following laparoscopic appendectomy is high with appropriate anticipatory guidance and preoperative education.
MeSH Keywords
patient discharge; appendectomy; satisfaction; quality improvement
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Additional Files
1351-Nelimar Cruz Centeno-Abstract.pdf (195 kB)Abstract
PSDA CYCLE SDD.docx (25 kB)
PSDA Cycle
Satisfaction with same-day discharge after laparoscopic appendectomy for non-perforated appendicitis
Problem Statement/Question: Our current practice is to discharge patients with non-perforated appendicitis the same day after laparoscopic appendectomy. However, caregivers might be apprehensive or anxious about being discharged from the hospital right after their child’s surgery.
Background/Project Intent (Aim Statement): Same-day discharge (SDD) after laparoscopic appendectomy for acute non-perforated appendicitis is safe, without an increased rate of postoperative complications, emergency department visits, or re-admissions. We aimed to evaluate caregiver satisfaction with this protocol.
Methods (include PDSA cycles): Patients discharged on the day of laparoscopic appendectomy for non-perforated acute appendicitis were identified between January 2022-August 2022. Surveys to evaluate satisfaction with the protocol were distributed to the caregivers via e-mail or text message 96 hours after discharge. Telephone surveys were conducted if there were no responses to the initial online survey. The surveys assessed comfort with SDD, post-operative pain control adequacy, post-operative provider contact, and overall satisfaction. The protocol focused on avoidance of narcotics in the postoperative period and immediate return to a regular diet.
Results: A total of 255 cases of non-perforated acute appendicitis underwent SDD. The survey response rate was 50.6% (n=129). Most respondents were Caucasian (69.0%, n=89) and male (51.9%, n=67), with a median age of 12.0 years (IQR 8.9,14.7). The median postoperative length of hospital stay was 3.8 hours (IQR 3.2,4.8). The overall satisfaction rate was 91.5%, with 118 caregivers feeling satisfied with SDD. Most caregivers felt comfortable with the SDD protocol (89.9%, n=116), with 22.5% (n=29) calling a medical provider postoperatively. Approximately nine out of ten caregivers reported that pain was adequately controlled (91.5%, n=118). In contrast, those that were dissatisfied reported issues with pain control and anxiety with SDD after a surgical procedure.
Conclusions: Caregiver satisfaction and comfort with same-day discharge following laparoscopic appendectomy is high with appropriate anticipatory guidance and preoperative education.
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