PenARC and University of Exeter researchers have published new research which could influence the management of hospital discharge for older people after surgery.
The report, funded by the National Institute for Health and Care Research (NIHR) is a comprehensive review, addressing gaps in knowledge around the impact of leaving hospital early after elective surgery for adults aged sixty or above.
Quicker patient turnaround times are one way of easing the burden on the NHS and reducing the risk of in-hospital complications such as falls or urinary infections. Previous research has found that leaving hospital earlier does not increase the risk of complications and readmission.
This research aimed to look in more detail at the implications of earlier discharge on patients and carers. Through two separate reviews of clinical and patient-reported outcomes and experiences, the researchers found that the best outcomes for older people usually happened when:
- They were asked about their quality of life and individual goals for recovery
- Follow-up care included information on medication use, further treatment, and advice about where to seek support
- Carers were involved in discharge plans and their concerns were considered
- An individual approach to patients was taken, including a familiar contact, such as a nurse, taking the time to explain the patient’s treatment and answer questions
- The patient was recognised as an active participant in their care, and as someone who can challenge themselves to achieve recovery targets and monitor their own progress, where feasible
Dr Michael Nunns, study lead researcher at the University of Exeter, said:
“Efforts to reduce length of stay in hospital after planned surgery have made great strides in recent years. This project gave us an important understanding of factors valued by patients and carers. However, many of the possible consequences that older adults and their families believe to be important following a stay in hospital have not been evaluated in research studies.”
Professor Jo Thompson-Coon, PenARC & University of Exeter Professor of Evidence Synthesis and Health Policy, said:
“We know interventions to reduce hospital length of stay for older adults following planned surgery are effective, without detriment to other patient outcomes. Our findings suggest that approaches that allow patients to understand their treatment, ask questions and build supportive relationships are likely to be more successful from the patient perspective. We hope these insights will inform the commissioning and delivery of services that support patients, carers and families before, during and after planned admission to hospital.”
Dr Nunns added:
“More work is needed to confidently make statements about what older adults, carers and primary/community care services feel about leaving hospital earlier after planned surgery. This is an important area in terms of its implications for the wider context of health and social care in the UK.”