Department of Surgery, Mount Sinai Hospital, Toronto, ON, Canada.
Department of Surgery, University of Toronto, Toronto, ON, Canada.
J Gastrointest Surg. 2017 Nov;21(11):1865-1878. doi: 10.1007/s11605-017-3573-0. Epub 2017 Sep 20.
With the adoption of enhanced recovery after surgery (ERAS) programs, patients are being discharged earlier and require more post-discharge teaching, educational materials, and information.
The purpose of this study is to assess satisfaction, discharge needs, and follow-up concerns of patients within an ERAS implementation program (iERAS).
Between 2012 and 2015, the iERAS program was undertaken at an academic hospital where 554 patients having elective colorectal surgery were enrolled. After discharge, patients were sent a survey containing multiple choice questions, preference ranking, and open-ended questions. Free-text responses were analyzed through a thematic approach.
Overall, 496 patients were mailed surveys and 219 (44.2%) completed the survey. Ninety-three percent were satisfied with the discharge information, and 90% felt they were ready for discharge. Eighty-six percent of patients saw their surgeon at 6 weeks, and 88% were satisfied with this follow-up plan. Some patients felt they had inadequate post-operative information, including how to resolve complications while at home and lack of reliable information for common post-operative occurrences. Patients with ostomies wanted more information about what to expect post-discharge and what symptoms were normal. Support from the homecare team and having a surgical nurse available were considered to be essential.
Improved post-operative education for surgical patients prior to discharge within iERAS is required to facilitate patient-centered discharge planning. Such interventions may help decrease unplanned hospital visits during the immediate post-discharge period.
随着术后加速康复（ERAS）方案的采用，患者出院更早，需要更多的出院后教学、教育材料和信息。
本研究旨在评估 ERAS 实施计划（iERAS）中患者的满意度、出院需求和随访关注点。
在 2012 年至 2015 年间，iERAS 计划在一家学术医院实施，共有 554 例择期结直肠手术患者入组。出院后，患者会收到一份包含多项选择题、偏好排序和开放式问题的调查问卷。通过主题分析对自由文本回复进行分析。
总体而言，有 496 名患者收到了调查问卷，其中 219 名（44.2%）完成了调查。93%的患者对出院信息感到满意，90%的患者觉得自己已经准备好出院。86%的患者在 6 周时看了他们的外科医生，88%对这个随访计划感到满意。一些患者觉得他们术后信息不足，包括如何在家中解决并发症以及缺乏常见术后情况的可靠信息。有造口的患者希望获得更多关于出院后预期和正常症状的信息。他们认为来自家庭护理团队的支持和有一名外科护士是必不可少的。
在 iERAS 中，需要在出院前为外科患者提供更好的术后教育，以促进以患者为中心的出院计划。这些干预措施可能有助于减少出院后立即的非计划性医院就诊。
