Department of Urology, North Bristol NHS Trust, Bristol Urological Institute, Bristol, UK
Department of Urology, Gloucestershire Hospitals NHS Foundation Trust, Cheltenham, Gloucestershire, UK.
BMJ Open Qual. 2020 Apr;9(2). doi: 10.1136/bmjoq-2018-000533.
Readmission from urological surgery is common, with a readmission rate for day case surgery of 3.7% and 26% for robot-assisted cystectomy. Readmission to secondary care and representation to primary care are both expensive and preventable. This project aimed to reduce both and also enhance the care of patients following urological surgery in a large tertiary referral centre, within the National Health Service. A retrospective telephone follow-up (TFU) survey was set up in the early postoperatively period to measure reattendance and readmission rates and perception of care received. Patients were also asked to suggest how improvement could be made. Quality improvement tools were used to optimise and review the methods and timing of TFU. TFU was initiated as a strategy to enhance care and reduce readmission rates. Phone calls were targeted to occur between 48 and 72 hours following discharge. During the intervention period, 484 phone calls were attempted with 343 being successful. Reattendance rates were reduced by 13% and patient satisfaction improved by 19.6%, following TFU. This intervention also generated additional income for the organisation and enhanced patient satisfaction in the early postoperative period.
泌尿科手术后的再入院很常见，日间手术的再入院率为 3.7%，机器人辅助膀胱切除术的再入院率为 26%。再次入住二级护理和初级护理都是昂贵且可预防的。该项目旨在减少这种情况，并在英国国家医疗服务体系内的一个大型三级转诊中心，提高泌尿科手术后患者的护理水平。在术后早期设置了回顾性电话随访（TFU）调查，以衡量再入院率和再入院率，并了解患者对所接受护理的看法。患者还被要求提出如何改进。质量改进工具被用于优化和审查 TFU 的方法和时间。TFU 是作为一种增强护理和降低再入院率的策略而发起的。电话呼叫的目标是在出院后 48 至 72 小时内进行。在干预期间，尝试了 484 次电话呼叫，其中 343 次成功。实施 TFU 后，再入院率降低了 13%，患者满意度提高了 19.6%。这项干预措施还为组织带来了额外的收入，并在术后早期提高了患者的满意度。
