Patient outcomes and provider perceptions following implementation of a standardized perioperative care pathway for open liver resection

2016 ◽  
Vol 103 (5) ◽  
pp. 564-571 ◽  
Author(s):  
A. J. Page ◽  
F. Gani ◽  
K. T. Crowley ◽  
K. H. K. Lee ◽  
M. C. Grant ◽  
...  
10.2196/20455 ◽  
2020 ◽  
Vol 22 (12) ◽  
pp. e20455
Author(s):  
Fabrice Ferré ◽  
Nicolas Boeschlin ◽  
Bruno Bastiani ◽  
Adeline Castel ◽  
Anne Ferrier ◽  
...  

Background Due to time limitations, the preanesthetic consultation (PAC) is not the best time for patients to integrate information specific to their perioperative care pathway. Objective The main objectives of this study were to evaluate the effectiveness of a digital companion on patients' knowledge of anesthesia and their satisfaction after real-life implementation. Methods We conducted a prospective, monocentric, comparative study using a before-and-after design. In phase 1, a 9-item self-reported anesthesia knowledge test (Delphi method) was administered to patients before and after their PAC (control group: PAC group). In phase 2, the study was repeated immediately after the implementation of a digital conversational agent, MyAnesth (@+PAC group). Patients’ satisfaction and their representations for anesthesia were also assessed using a Likert scale and the Abric method of hierarchized evocation. Results A total of 600 tests were distributed; 205 patients and 98 patients were included in the PAC group and @+PAC group, respectively. Demographic characteristics and mean scores on the 9-point preinformation test (PAC group: 4.2 points, 95% CI 3.9-4.4; @+PAC: 4.3 points, 95% CI 4-4.7; P=.37) were similar in the two groups. The mean score after receiving information was better in the @+PAC group than in the PAC group (6.1 points, 95% CI 5.8-6.4 points versus 5.2 points, 95% CI 5.0-5.4 points, respectively; P<.001), with an added value of 0.7 points (95% CI 0.3-1.1; P<.001). Among the respondents in the @+PAC group, 82% found the information to be clear and appropriate, and 74% found it easily accessible. Before receiving information, the central core of patients’ representations for anesthesia was focused on the fear of being put to sleep and thereafter on caregiver skills and comfort. Conclusions The implementation of our digital conversational agent in addition to the PAC improved patients' knowledge about their perioperative care pathway. This innovative audiovisual support seemed clear, adapted, easily accessible, and reassuring. Future studies should focus on adapting both the content and delivery of a digital conversational agent for the PAC in order to maximize its benefit to patients.


2020 ◽  
pp. 3860-3866
Author(s):  
Tom Abbott ◽  
Rupert Pearse

The assessment of patients before surgery is complex. However, since surgery is offered to increasing numbers of patients with multiple comorbidities, the demand for comprehensive preoperative assessment is expected to increase. Perioperative medicine provides a patient-centred approach from preoperative assessment through to hospital discharge and beyond. Preoperative assessment serves to identify comorbidity that may require optimization before surgery, plan perioperative care, identify a need for a non-standard anaesthetic technique, assess functional reserve, brief patients on the perioperative care pathway, and provide an opportunity to have questions answered. There are a variety of tools for preoperative assessment and recognized approaches to managing patients with existing chronic disease during the perioperative period, but the absence of robust evidence to favour any particular clinical approach is striking.


Brachytherapy ◽  
2015 ◽  
Vol 14 (1) ◽  
pp. 91-92
Author(s):  
Alison A. Nielsen ◽  
Tehani A. Liyanage ◽  
Gary S. Leiserowitz ◽  
Jyoti S. Mayadev

2019 ◽  
Vol 26 (10) ◽  
pp. 3354-3360 ◽  
Author(s):  
Alysha R. Keehn ◽  
David W. Olson ◽  
Joseph C. Dort ◽  
Shannon Parker ◽  
Susan Anderes ◽  
...  

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Marc Weijie Ong ◽  
Serene Si Ning Goh ◽  
Wei Min James Tung ◽  
Woan Wui Lim ◽  
Hilda Haoling Hu ◽  
...  

2020 ◽  
Author(s):  
Fabrice Ferré ◽  
Nicolas Boeschlin ◽  
Bruno Bastiani ◽  
Adeline Castel ◽  
Anne Ferrier ◽  
...  

BACKGROUND Due to time limitations, the preanesthetic consultation (PAC) is not the best time for patients to integrate information specific to their perioperative care pathway. OBJECTIVE The main objectives of this study were to evaluate the effectiveness of a digital companion on patients' knowledge of anesthesia and their satisfaction after real-life implementation. METHODS We conducted a prospective, monocentric, comparative study using a before-and-after design. In phase 1, a 9-item self-reported anesthesia knowledge test (Delphi method) was administered to patients before and after their PAC (control group: PAC group). In phase 2, the study was repeated immediately after the implementation of a digital conversational agent, MyAnesth (@+PAC group). Patients’ satisfaction and their representations for anesthesia were also assessed using a Likert scale and the Abric method of hierarchized evocation. RESULTS A total of 600 tests were distributed; 205 patients and 98 patients were included in the PAC group and @+PAC group, respectively. Demographic characteristics and mean scores on the 9-point preinformation test (PAC group: 4.2 points, 95% CI 3.9-4.4; @+PAC: 4.3 points, 95% CI 4-4.7; <i>P</i>=.37) were similar in the two groups. The mean score after receiving information was better in the @+PAC group than in the PAC group (6.1 points, 95% CI 5.8-6.4 points versus 5.2 points, 95% CI 5.0-5.4 points, respectively; <i>P</i>&lt;.001), with an added value of 0.7 points (95% CI 0.3-1.1; <i>P</i>&lt;.001). Among the respondents in the @+PAC group, 82% found the information to be clear and appropriate, and 74% found it easily accessible. Before receiving information, the central core of patients’ representations for anesthesia was focused on the fear of being put to sleep and thereafter on caregiver skills and comfort. CONCLUSIONS The implementation of our digital conversational agent in addition to the PAC improved patients' knowledge about their perioperative care pathway. This innovative audiovisual support seemed clear, adapted, easily accessible, and reassuring. Future studies should focus on adapting both the content and delivery of a digital conversational agent for the PAC in order to maximize its benefit to patients.


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