Assessing a Tool to Measure Patient Functional Ability After Outpatient Surgery

Hogue, Susan; Reese, Pat Ray; Colopy, Michael W.; Fleisher, Lee A.; Tuman, Kenneth J.; Twersky, Rebecca S.; Warner, David S.; Jamerson, Brenda D.

doi:10.1097/00000539-200007000-00019

Cited by 29 publications

(39 citation statements)

References 5 publications

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“…Initially, we searched the literature and found several postoperative assessment scores [12, 15–22]. Since we found no simple system constructed for global monitoring of the general status, as well as efficacy and side - effects of pain treatment after discharge from PACU, we developed a prototype score tool, “the Kongsberg satisfaction score”, (KSS) for this purpose.…”

Section: Methodsmentioning

confidence: 99%

Development and validation of the Efficacy Safety Score (ESS), a novel tool for postoperative patient management

et al. 2017

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BackgroundSeveral reports have shown that postoperative monitoring of general safety and quality issues, including pain treatment, after discharge from recovery is often non-systematic and inadequate. We suggest a new score with assessment of key recovery parameters, as a supportive tool for postoperative care and a call-out algorithm for need of extra help. The aim of this investigation was to validate the score.MethodsAfter suggesting a prototype score from a pilot study in 182 postoperative patients, we performed a Delphi process by using international experts to create consensus on the final score contents and called the revised tool the Efficacy Safety Score (ESS). Then, we performed a prospective observational study with the ESS throughout the first 24 h postoperatively in 207 surgical in-patients. We compared ESS with Modified Early Warning Systems (MEWS), and postoperative journal information. We subsequently validated ESS by addressing recognized quality criteria for measurement of health status questionnaires.ResultsA call-out value of ESS ≥10 correlated with MEWS > 0 values and journal information about postoperative concerns with a sensitivity of 94% and 92%, respectively. All serious safety issues were identified with the ESS ≥ 10, and a higher number of quality issues were identified than with routine care or MEWS. We obtained positive ratings for six out of seven tested criteria of questionnaire quality; one criterion had an indeterminate rating.ConclusionESS fulfils suggested criteria for score quality validation and reflects the patient’s postoperative status adequately and with high sensitivity. Further clinical trials are warranted to evaluate the usefulness of ESS as a simple tool for assessment of the postoperative safety and quality of patients.Electronic supplementary materialThe online version of this article (doi:10.1186/s12871-017-0344-0) contains supplementary material, which is available to authorized users.

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Section: Methodsmentioning

confidence: 99%

Development and validation of the Efficacy Safety Score (ESS), a novel tool for postoperative patient management

et al. 2017

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“…The recovery phases described by these tools can be categorised as early, intermediate and late. The early postoperative recovery phase has been defined as the first 24 h or the first seven days . The speed and extent of recovery in the early phase is influenced most by pain, nausea, peri‐operative medications and delirium .…”

Section: Recovery Time Periods – Relevance Influences and Focusmentioning

confidence: 99%

Postoperative recovery and outcomes – what are we measuring and for whom?

2015

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SummaryRecovery is an abstract quantity the definition of which varies according to the pre-dilection of individual institutions, clinicians or patients. While traditionally focused on immediate postoperative restitution of function and readiness for discharge, recovery assessment has progressively expanded its focus to include other clinically relevant time periods, each of which is influenced by specific factors. Assessment tools have progressed from assessing one dimension of recovery, such as physiological variables, to multidimensional assessment of physical, nociceptive, emotive, functional and cognitive performance. They should be validated ideally for repeat measures and should provide realtime recovery data, as recovery can be viewed as a continuous process. Recovery time periods -relevance, influences and focus Postoperative recovery is complete when function is restored and adverse symptoms have resolved. Function and symptoms can be assessed at time points considered significant by the patient, clinician or institution.The outcomes of the 'enhanced recovery after surgery' pathways were initially determined by clinicians rather than patients, and emphasised what happened in hospital -length of hospital stay, complications and early organ dysfunction [1]. However, reductions in length of hospital stay and complications associated with the enhanced recovery pathway are of limited interest to patients [2,3]. Patients rarely achieve normal levels of function and are usually symptomatic on discharge after major surgery, the timing of which is influenced by organisational factors and correlates poorly with longer term recovery [1,2].Postoperative enhanced recovery, as a process and as an endpoint, is now assessed during three stages: from the end of surgery to discharge from the postanaesthetic care unit; from then until hospital discharge; and, finally, until normal function has been restored. Simple physiological variables predominantly influence the first stage. The second and third stages are predominantly influenced by pain, more complex physiology and function.Tools generated by clinicians from various specialties, rather than just surgery, also define recovery over three phases, their cumulative duration exceeding 72

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“…All aspects are important not only as such but also as a basis for an overall scale of recovery. A common approach to creating one single score out of a previously developed multi-item instrument is to use sum scores [8,9,[18][19][20][21][22][23][24]. However, assessments of rating scales generate ordered categorical data having an ordered structure only, with no other mathematical properties, even though the use of numerical labels gives a false impression of that.…”

Section: Discussionmentioning

confidence: 99%