Parental Satisfaction with Same-Day Discharge after Laparoscopic Appendectomy for Uncomplicated Appendicitis

Ngo, Sandra; Gee, Kristin M.; Burkhalter, Lorrie S.; Beres, Alana L.

doi:10.1016/j.jamcollsurg.2017.07.825

Cited by 2 publications

(6 citation statements)

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“…Our study demonstrated no change to pLOS following CLD introduction, which remained approximately 24 h. These results were unexpected and at odds with previous evidence suggesting that introduction of discharge protocols following appendicectomy consistently reduced pLOS 5–18 . We do note that our result was statistically limited by the fact that many patients did not complete the CLD protocol.…”

Section: Discussioncontrasting

confidence: 88%

“…[5][6][7][8][9][10][11][12][13][14][15][16][17][18] Of these, only two paediatric studies specifically reported parent satisfaction following expedited discharge post-appendicectomy. 8,10 Both reported positive responses, though neither made a direct comparison to satisfaction following standard discharge.…”

Section: What This Paper Addsmentioning

confidence: 99%

“…Discharge from hospital following appendicectomy for SA should be safe for patients, prevent complications and proceed in an efficient and timely manner. Several studies have previously investigated expediting discharge following appendicectomy for SA, often utilising a protocol to reduce post‐operative length of stay (pLOS) 5–18 . These studies have uniformly found that expedited discharge practices decrease pLOS without increasing complications 5–18 .…”

mentioning

confidence: 99%

“…Several studies have previously investigated expediting discharge following appendicectomy for SA, often utilising a protocol to reduce post‐operative length of stay (pLOS) 5–18 . These studies have uniformly found that expedited discharge practices decrease pLOS without increasing complications 5–18 . Of these, only two paediatric studies specifically reported parent satisfaction following expedited discharge post‐appendicectomy 8,10 .…”

mentioning

confidence: 99%

“…These studies have uniformly found that expedited discharge practices decrease pLOS without increasing complications 5–18 . Of these, only two paediatric studies specifically reported parent satisfaction following expedited discharge post‐appendicectomy 8,10 . Both reported positive responses, though neither made a direct comparison to satisfaction following standard discharge.…”

mentioning

confidence: 99%

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Criteria‐led discharge for simple appendicitis in children: A pilot study

Roddis

Ensor

Williamson

et al. 2022

J Paediatrics Child Health

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Aim: Criteria-led discharge (CLD) protocols have been suggested to increase efficiency of discharge from hospital following surgical interventions. Our aim was to assess the feasibility, clinical outcomes and parental satisfaction following the introduction of a pilot CLD for simple appendicitis (SA) in children. Methods: A prospective pilot cohort study was conducted including paediatric patients with SA who were managed with CLD and a control group who were managed with standard discharge procedures. A CLD pro forma was developed, standardising care guidelines and clinical criteria indicators to be met for children to be discharged post-operatively. A post-discharge parent survey was also utilised. The primary outcome measure was post-operative length of stay (pLOS), with secondary outcomes of post-operative complication rates and parental satisfaction. Results: The control group consisted of 31 patients and CLD group 35 patients. There was no difference in the median pLOS (24 [16.7-44.6] vs. 25.3 [19.1-50.1] h, P = 0.3). Furthermore, there were no significant differences on any of the secondary outcomes. Parental confidence with time of discharge was very high in both control (85.7%) and CLD (88.2%) groups (P = 1.0). Conclusion:The introduction of CLD is safe and feasible. Whilst this pilot has not demonstrated a reduction in pLOS, our data suggest that it is well accepted by the parents.

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Section: Discussioncontrasting

confidence: 88%

Section: What This Paper Addsmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Criteria‐led discharge for simple appendicitis in children: A pilot study

Roddis

Ensor

Williamson

et al. 2022

J Paediatrics Child Health

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Value Added from Same-day Discharge after Appendectomy for Children with Simple Appendicitis

Juviler

Wilson

Livingston

et al. 2023

Pediatric Quality &Amp; Safety

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Introduction: Same-day discharge of children after appendectomy for simple appendicitis is safe and associated with enhanced parent satisfaction. Our general pediatric surgeons aimed to improve the rate of same-day discharge after appendectomy for simple appendicitis. Methods: We implemented a clinical practice guideline in September 2019. A surgeon-of-the-week service model and the urgent operating room started in November 2019 and January 2020, respectively. Data for children with simple appendicitis from our academic medical center were gathered prospectively using National Surgical Quality Improvement Program-Pediatric. Patient outcomes before intervention implementation (n = 278) were compared with patients following implementation (n = 264). Results: The average monthly percentage of patients discharged on the day of surgery increased in the postimplementation group (32% versus 75%). Median postoperative length of stay decreased [16.5 hours (interquartile range, 15.9) versus 4.4 hours (interquartile range, 11.7), P < 0.001], and the proportion of patients discharged directly from the postoperative anesthesia care unit increased (22.8% versus 43.6%; P < 0.001). There were no differences in balancing measures, including the return to the emergency department and readmission. Fewer children were discharged home on oral antibiotics after implementation (6.8% versus 1.5%, P = 0.002), and opioid prescribing at discharge remained low (2.5% versus 1.1%, P = 0.385). Conclusions: Using quality improvement methodology and care standardization, we significantly improved the rate of same-day discharge after appendectomy for simple appendicitis without impacting emergency department visits or readmissions. As a result, our health care system saved 140 hospital days over the first 21 months.

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Parental Satisfaction with Same-Day Discharge after Laparoscopic Appendectomy for Uncomplicated Appendicitis

Cited by 2 publications

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Criteria‐led discharge for simple appendicitis in children: A pilot study

Criteria‐led discharge for simple appendicitis in children: A pilot study

Value Added from Same-day Discharge after Appendectomy for Children with Simple Appendicitis

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