B Hackman1, N Navaneethan. 1. Department of Obstetrics and Gynaecology, Peterborough District Hospital, UK.
Abstract
OBJECTIVE: To determine the safety and acceptability of early discharge after major gynaecological surgery. DESIGN: Retrospective study of patients discharged home on the third day after surgery. Questionnaire to determine patients' attitudes. SETTING: District general hospital with an associated 'Hospital at Home Scheme'. SUBJECTS: 102 women listed for major gynaecological surgery living within the catchment area of the Hospital at Home and considered good surgical risks. MAIN OUTCOME MEASURES: Safety, re-admission rates, nursing time planned and utilised, patients' attitudes. RESULTS: There were no serious complications. Only three patients required re-admission. Less nursing time was required than expected: allocated, 24 h; utilised, less than 10 h for 45%; no night cover for 70.5%. Patient aides performed most of the nursing. There was no excess burden for general practice (45.7% required a home visit). The scheme proved popular with patients. Analgesia and catheter care needed to be improved. CONCLUSION: Discharge on the third postoperative day into an augmented domiciliary care service is safe, popular and cost effective.
OBJECTIVE: To determine the safety and acceptability of early discharge after major gynaecological surgery. DESIGN: Retrospective study of patients discharged home on the third day after surgery. Questionnaire to determine patients' attitudes. SETTING: District general hospital with an associated 'Hospital at Home Scheme'. SUBJECTS: 102 women listed for major gynaecological surgery living within the catchment area of the Hospital at Home and considered good surgical risks. MAIN OUTCOME MEASURES: Safety, re-admission rates, nursing time planned and utilised, patients' attitudes. RESULTS: There were no serious complications. Only three patients required re-admission. Less nursing time was required than expected: allocated, 24 h; utilised, less than 10 h for 45%; no night cover for 70.5%. Patient aides performed most of the nursing. There was no excess burden for general practice (45.7% required a home visit). The scheme proved popular with patients. Analgesia and catheter care needed to be improved. CONCLUSION: Discharge on the third postoperative day into an augmented domiciliary care service is safe, popular and cost effective.