Villatoro Bonilla Mario Antonio, Sarmiento Bonilla Cristian Israel, Rojas Herrera Maria Fernanda Desirée, Herrera Palacios Felgir Josué Noé, Ramírez Pineda Mauricio David, Vega Solano Manrique
Surgical Oncology, Instituto Salvadoreño del Seguro Social, San Salvador, SLV.
Surgery, Hospital de Especialidades UMAE (Unidad Médica de Alta Especialidad) No. 71, Torreón, MEX.
Cureus. 2025 Aug 16;17(8):e90207. doi: 10.7759/cureus.90207. eCollection 2025 Aug.
This review stems from the rising fragmentation of surgical care as care tends to get transferred among several teams and between several providers, leaving patients confused and unsatisfied. This fragmentation can lead to worse clinical outcomes, especially among high risks surgery patients. The review aims to examine how continuity of surgical care affects recovery, complication management, and patient satisfaction. Comprehensive discharge planning, individualized patient education, timely follow-up (especially with the operating surgeon or through home visits by familiar providers), and the integration of Advanced Practice Providers can substantially reduce readmissions. While common, follow-up phone calls alone were not consistently sufficient to reduce readmissions. Care fragmentation, particularly the absence of surgeon care continuity during readmission, has been independently associated with increased 30-day mortality and a longer time to receive necessary interventions. Technological interventions like telemedicine offer promising avenues for remote monitoring, education, and consultation, leading to improved patient satisfaction, reduced costs, and lower readmission rates across various surgical specialties. Additionally, peer mentoring programs can effectively reduce patient anxiety and facilitate earlier communication of complications, even if this results in an increase in beneficial early readmissions. Enhanced Recovery After Surgery (ERAS) protocols have also demonstrated effectiveness in shortening length of stay and improving recovery. This review reinforces the critical importance of understanding and improving SCOC as a cornerstone of patient-centered care. By bridging the gap between hospital discharge and home recovery, effective SCOC interventions can demonstrably improve patient outcomes, reduce burdensome readmissions, enhance patient satisfaction, and elevate overall quality of life. The complexity of the concept of continuity of care, affecting clinical, informational, and relational dimensions, pinpoints the necessity of the join and concerted efforts at the healthcare continuum.
本综述源于外科护理日益碎片化的现象,因为护理往往在多个团队和多个提供者之间转移,这让患者感到困惑和不满。这种碎片化可能导致更差的临床结果,尤其是在高风险手术患者中。本综述旨在研究外科护理的连续性如何影响康复、并发症管理和患者满意度。全面的出院计划、个性化的患者教育、及时的随访(尤其是与主刀医生或由熟悉的提供者进行家访)以及高级实践提供者的整合可以大幅减少再入院率。虽然常见,但仅靠随访电话并不总能充分减少再入院率。护理碎片化,尤其是再入院期间缺乏外科医生护理的连续性,已被独立证明与30天死亡率增加和接受必要干预的时间延长有关。远程医疗等技术干预为远程监测、教育和咨询提供了有前景的途径,从而提高患者满意度、降低成本并降低各个外科专科的再入院率。此外,同伴指导计划可以有效减轻患者焦虑并促进并发症的早期沟通,即使这会导致有益的早期再入院率增加。术后加速康复(ERAS)方案也已证明在缩短住院时间和改善康复方面有效。本综述强化了理解和改善外科护理连续性作为以患者为中心的护理基石的至关重要性。通过弥合医院出院和家庭康复之间的差距,有效的外科护理连续性干预措施可以显著改善患者预后、减少繁重的再入院、提高患者满意度并提升整体生活质量。护理连续性概念的复杂性影响临床、信息和关系维度,突出了在医疗保健连续过程中联合和共同努力的必要性。