Implementation of 23 Hour Surgery Model in a Tertiary Hospital

Study Overview
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Brief Summary
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Extended day surgery or 23 h surgery (23-hour surgery) is a surgical model where patients arrive to the hospital from home at the day of surgery, are operated and recover in a 23 h surgery unit. 23H surgery units are usually situated near postoperative recovery unit. THe 23 H surgical model was implemented in Kuopio University Hospital 2015 and between May 2017-May 2018 patients were recruited in the present prospective follow up cohort study. Patients were informed and they gave their informed consent. The patients were contacted two weeks after the study and details of their recovery were asked.

Detailed Description
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Extended day surgery or 23 h surgery is a surgical model where patients arrive to the hospital from home at the day of surgery, are operated and recover in a 23 h surgery unit. 23H surgery units are usually situated near postoperative recovery unit. THe 23 H surgical model was implemented in Kuopio University Hospital 2015 and between May 2017-May 2018 patients were recruited in the present prospective follow up cohort study. Patients were informed and they gave their informed consent. The patients were contacted two weeks after the study and details of their recovery were asked. Satisfaction to the care in 23 h unit and surgical process, were asked. Amount of readmissions, reoperations, contacts to health care professionals and adverse events are recorded. Detailed information about intensity of pain, analgesic need and use in the hospital was recorded and pain interference in daily life for short term recovery period was asked.

Official Title
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23 Hour Surgical Model in a Tertiary Hospital: Evaluation From Patient and Organisational Perspective

Conditions
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Ovarian Cysts, Ambulatory Surgery, Laparoscopy, Shoulder Impingement Syndrome, Cholecystolithiasis, Appendicitis, Gynecologic Surgical Procedures, Ambulatory Surgical Procedures, Neurosurgery

Intervention / Treatment
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* Other: 23 h surgery


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: adult gave informed consent Exclusion Criteria: no informed consent

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 100 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| 23 h surgery<br>Adult patients who were treated in 23 h surgical unit | Other: 23 h surgery<br>* Patients were treated in 23 surgical unit<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Amount of patients discharged from the hospital until 10 am at the first postoperative day | The amount of patients discharged from hospital by the first postoperative day 10 am | Postoperative day 1 | 
| Pain intensity postoperatively | Pain intensity after surgery for the first 24 hours | Postoperative day 1 | 
| Analgesic consumption postoperatively | Amount of different analgesics consumed during the 24 h period postoperatively | Postoperative day 1 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| 30 days readmission rate | How many patients are admitted to hospital within 30 postoperative days | one month after surgery | 
| 30 days reoperation rate | How many patients are reoperated within 30 postoperative days | one month after surgery | 
| Number of adverse events during 14 postoperative days | Amount of adverse events after surgery within 14 postoperative days | 14 days after surgery | 
| Contact to health care during 14 postoperative days | Number of contacts to health care within 14 postoperative days | 14 days afte surgery | 
| Patient satisfaction to care in 23 hours process | Scale 0-7 (0= not satisfied, 7 =very satisfied), the higher score the better result | 14 days after surgery | 
| Proportion of patients having pain postoperatively | Amount of patients who had pain still two weeks after surgery | Two weeks postoperatively | 
| Postoperative pain interference after 23 h surgery | Patient assessed pain interference in daily activities up to 2 weeks after surgery | two weeks postoperatively | 
| Analgesic use after 23 h surgery | amount of patients using analgesics two weeks after surgery | Two weeks postoperatively | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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23 h surgery, postoperative recovery, outcome, patient satisfaction, postoperative pain, analgesic, oxycodone, multimodal pain management, extended day surgery