Surgery Clinical Trial
Official title:
Redesigning Pre-surgery Patient Journeys With Telehealth
Prior to surgery, patients undergo preanaesthesia assessment to ensure timely optimisation of medical conditions that could adversely impact perioperative outcomes. At the Preadmission Service (PAS) clinic of KK hospital, nurses perform the first triage to identify patients who require outpatient anaesthetic review in advance of surgery. While all elective patients attend the PAS clinic, only 8% are require outpatient anaesthetic review. The majority 92%, can be safely triaged to receive preanaesthesia assessment on the day of surgery. In this project, we propose to investigate the efficacy of a new pre-surgery workflow for elective surgical patients incorporating telehealth. We hypothesize that the redesigned pre-surgery journey incorporating telehealth reduces in-person consultation at the pre-admission clinic by up to 90%. Primary outcome is the proportion of eligible same-day-admission patients assessed via telehealth. Secondary outcomes are: 1. Patient cost and time savings 2. Patient experience of the new model of care 3. Staff experience of the new workflow 4. Incidence of day-of-surgery cancellations
Status | Recruiting |
Enrollment | 258 |
Est. completion date | December 2025 |
Est. primary completion date | December 2024 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 21 Years to 70 Years |
Eligibility | Inclusion Criteria: - Patient participants: Age 21 to 70 years Listed for elective surgery English literacy Willing to provide signed consent Of any nationality Able to give own legal consent Exclusion Criteria: - Healthcare participants: Age 21 to 70 years Healthcare professionals comprising clinic staff (surgical outpatient clinics, PAS), clinicians (anaesthetists, surgeons), and health service managers) |
Country | Name | City | State |
---|---|---|---|
Singapore | KK Women's and Children's Hospital | Singapore |
Lead Sponsor | Collaborator |
---|---|
KK Women's and Children's Hospital | Duke-NUS Graduate Medical School, Nanyang Technological University |
Singapore,
Applegate RL 2nd, Gildea B, Patchin R, Rook JL, Wolford B, Nyirady J, Dawes TA, Faltys J, Ramsingh DS, Stier G. Telemedicine pre-anesthesia evaluation: a randomized pilot trial. Telemed J E Health. 2013 Mar;19(3):211-6. doi: 10.1089/tmj.2012.0132. Epub 20 — View Citation
Donelan K, Barreto EA, Sossong S, Michael C, Estrada JJ, Cohen AB, Wozniak J, Schwamm LH. Patient and clinician experiences with telehealth for patient follow-up care. Am J Manag Care. 2019 Jan;25(1):40-44. — View Citation
Mullen-Fortino M, Rising KL, Duckworth J, Gwynn V, Sites FD, Hollander JE. Presurgical Assessment Using Telemedicine Technology: Impact on Efficiency, Effectiveness, and Patient Experience of Care. Telemed J E Health. 2019 Feb;25(2):137-142. doi: 10.1089/ — View Citation
Murray E, Treweek S, Pope C, MacFarlane A, Ballini L, Dowrick C, Finch T, Kennedy A, Mair F, O'Donnell C, Ong BN, Rapley T, Rogers A, May C. Normalisation process theory: a framework for developing, evaluating and implementing complex interventions. BMC M — View Citation
Wong DT, Kamming D, Salenieks ME, Go K, Kohm C, Chung F. Preadmission anesthesia consultation using telemedicine technology: a pilot study. Anesthesiology. 2004 Jun;100(6):1605-7. doi: 10.1097/00000542-200406000-00038. No abstract available. — View Citation
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Proportion of eligible elective surgery patients assessed successfully via telehealth for preoperative evaluation | Of the total number of patients booked for elective surgery, the proportion of patients evaluated preoperatively by telehealth is measured. | One year from the initiation of the implementation phase (Phase 3) | |
Secondary | Patient's perception and attitude towards a Telehealth model of care for preoperative evaluation | Quantitative study via one-on-one semi-structured interviews of elective surgery patients to evaluate their attitudes and perception of the new proposed telehealth workflow conducted in (Service Redesign) Phase 1 | 5 months from July to November 2021 | |
Secondary | Healthcare providers' perception and attitude towards a Telehealth model of care for preoperative evaluation | Quantitative study via one-on-one semi-structured interviews of healthcare providers working in the peroperative and surgery clinics to evaluate their attitudes and perception of the new proposed telehealth workflow conducted in (Service Redesign) Phase 1 | 5 months from July to November 2021 |
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