Neurosurgical Transitional Care Programme

Summary

Readmissions increasingly serve as a metric of hospital performance, inviting quality improvement initiatives in both medicine and surgery. Recently, a readmission reduction program in the United States was associated with significantly shorter length of stay, earlier discharge, and reduced 30-day readmission after elective neurosurgery. These results underscore the importance of patient education and surveillance after hospital discharge, and it would be beneficial to test whether the same approach yields beneficial results in a different health system, the NHS. In this study, the investigators will replicate the Transitional Care Program (TCP) with the goal of decreasing length of stay, improving discharge efficiency, and reducing readmissions in neurosurgical patients by optimizing patient education and post-discharge surveillance.

Conditions

• Surgery
• Brain Tumor
• Brain Tumor, Recurrent
• Brain Pathology
• Spinal Diseases
• Spinal Stenosis
• Spinal Fusion
• Trigeminal Neuralgia
• Hydrocephalus
• Fusion of Spine
• Aneurysm
• SPINAL Fracture
• Chiari; Net
• Skull Injuries
• Brain Cancer
• Brain Metastases
• Brain Diseases
• Brain Lesion
• Brain Cyst
• Spinal Curvature
• Spinal Instability
• Spinal Cord Neoplasms

Interventions

OTHER

Transitional Care Programme

These patients will receive a pre-admission overview of their surgery, an anticipated discharge date, and a pre-scheduled discharge appointment to set patient expectations for a shorter hospitalization. On the day of discharge, the patient and his or her caregiver will attend an extended discharge appointment with a TCP-trained nurse. Finally, patients will receive a surveillance phone call 48 hours after discharge.

Sponsors & Collaborators

• Brigham and Women's Hospital

  collaborator OTHER

• Harvard Medical School (HMS and HSDM)

  collaborator OTHER

• Barts & The London NHS Trust

  lead OTHER

Principal Investigators

• Edward McKintosh, FRCS(SN) PhD · Barts Health

Study Design

Allocation

RANDOMIZED

Purpose

HEALTH_SERVICES_RESEARCH

Masking

NONE

Model

PARALLEL

Eligibility

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2019-05-30

Primary Completion

2019-08-18

Completion

2019-08-30

Countries

• United Kingdom

Study Locations