Neurosurgical enhanced recovery after surgery (ERAS) programme for elective craniotomies: are patients satisfied with their experiences? A quantitative and qualitative analysis

Objective To evaluate patient satisfaction and associated predictors at discharge, as well as patient experience at 30-day follow-up, in a neurosurgical enhanced recovery after surgery (ERAS) programme.Design A single-centre, prospective, randomised controlled study.Setting A tertiary hospital in Ch...

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Main Authors: Lei Chen, Bolin Liu, Shujuan Liu, Yuan Wang, Binfang Zhao, Tianzhi Zhao, Lanfu Zhao, Wenhai Lv, Yufu Zhang, Tao Zheng, Yafei Xue, Long Chen, Yingxi Wu, Guodong Gao, Yan Qu, Shiming He
Format: Article
Language:English
Published: BMJ Publishing Group 2019-11-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/9/11/e028706.full
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author Lei Chen
Bolin Liu
Shujuan Liu
Yuan Wang
Binfang Zhao
Tianzhi Zhao
Lanfu Zhao
Wenhai Lv
Yufu Zhang
Tao Zheng
Yafei Xue
Long Chen
Yingxi Wu
Guodong Gao
Yan Qu
Shiming He
author_facet Lei Chen
Bolin Liu
Shujuan Liu
Yuan Wang
Binfang Zhao
Tianzhi Zhao
Lanfu Zhao
Wenhai Lv
Yufu Zhang
Tao Zheng
Yafei Xue
Long Chen
Yingxi Wu
Guodong Gao
Yan Qu
Shiming He
author_sort Lei Chen
collection DOAJ
description Objective To evaluate patient satisfaction and associated predictors at discharge, as well as patient experience at 30-day follow-up, in a neurosurgical enhanced recovery after surgery (ERAS) programme.Design A single-centre, prospective, randomised controlled study.Setting A tertiary hospital in China.Participants A total of 140 neurosurgical patients aged 18–65 years old who had a single intracranial lesion and were admitted for elective craniotomy between October 2016 and July 2017 were included.Interventions Patients were randomised into two groups: 70 patients received care according to a novel neurosurgical ERAS protocol (ERAS group) and 70 patients received conventional perioperative care (control group).Outcome measures Patient satisfaction at discharge was evaluated using a multimodal questionnaire. A secondary analysis of patient experience regarding participation in the ERAS programme was conducted using a semistructured qualitative interview via telephone at 30-day follow-up.Results The mean patient satisfaction was significantly higher in the ERAS group than in the control group at discharge (92.2±4.3 vs 86.8±7.4, p=0.0001). The most important predictors of patient satisfaction included age (OR=6.934), postoperative nausea and vomiting (PONV) Visual Analogue Scale (VAS) score (OR=0.184), absorbable skin suture (OR=0.007) and postoperative length of stay (LOS) (OR=0.765). Analysis on patient experience revealed five themes: information transfer, professional support, shared responsibility and active participation, readiness for discharge, and follow-up, all of which are closely related and represent positive and negative aspects.Conclusions Measures that include decreasing PONV VAS score, incorporating absorbable skin suture and shortening LOS seem to increase patient satisfaction in a neurosurgical ERAS programme. Analysis of data on patient experience highlights several aspects to achieve patient-centred and high-quality care. Further studies are warranted to standardise the assessment of patient satisfaction and experience in planning, employing and appraising the ERAS programme.Trial registration number ChiCTR-INR-16009662.
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spelling doaj-art-7a94e3b85e714698b6f83577e30f09362024-11-29T11:35:09ZengBMJ Publishing GroupBMJ Open2044-60552019-11-0191110.1136/bmjopen-2018-028706Neurosurgical enhanced recovery after surgery (ERAS) programme for elective craniotomies: are patients satisfied with their experiences? A quantitative and qualitative analysisLei Chen0Bolin Liu1Shujuan Liu2Yuan Wang3Binfang Zhao4Tianzhi Zhao5Lanfu Zhao6Wenhai Lv7Yufu Zhang8Tao Zheng9Yafei Xue10Long Chen11Yingxi Wu12Guodong Gao13Yan Qu14Shiming He151 State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis andTherapy, Sun Yat-sen University Cancer Center, GuangZhou, ChinaDepartment of Neurosurgery, Xi`an International Medical Center, Xi`an, Shaanxi Province, China3 Department of Obstetrics and Gynecology, Xijing Hospital, Fourth Military Medical University, Xi’an, ChinaDepartment of Neonatology, Chengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China2 Department of Neurosurgery, Tangdu Hospital, Fourth Military Medical University, Xi’an, China2 Department of Neurosurgery, Tangdu Hospital, Fourth Military Medical University, Xi’an, China2 Department of Neurosurgery, Tangdu Hospital, Fourth Military Medical University, Xi’an, China2 Department of Neurosurgery, Tangdu Hospital, Fourth Military Medical University, Xi’an, China2 Department of Neurosurgery, Tangdu Hospital, Fourth Military Medical University, Xi’an, ChinaDepartment of Neurosurgery, Xi`an International Medical Center, Xi`an, Shaanxi Province, China2 Department of Neurosurgery, Tangdu Hospital, Fourth Military Medical University, Xi’an, ChinaLaboratory of Transplantation Immunotherapy, Cellular and Molecular Therapeutics Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA2 Department of Neurosurgery, Tangdu Hospital, Fourth Military Medical University, Xi’an, China2 Department of Neurosurgery, Tangdu Hospital, Fourth Military Medical University, Xi’an, ChinaGenentech, Inc., South San Francisco, CA, USADepartment of Neurosurgery, Xi`an International Medical Center, Xi`an, Shaanxi Province, ChinaObjective To evaluate patient satisfaction and associated predictors at discharge, as well as patient experience at 30-day follow-up, in a neurosurgical enhanced recovery after surgery (ERAS) programme.Design A single-centre, prospective, randomised controlled study.Setting A tertiary hospital in China.Participants A total of 140 neurosurgical patients aged 18–65 years old who had a single intracranial lesion and were admitted for elective craniotomy between October 2016 and July 2017 were included.Interventions Patients were randomised into two groups: 70 patients received care according to a novel neurosurgical ERAS protocol (ERAS group) and 70 patients received conventional perioperative care (control group).Outcome measures Patient satisfaction at discharge was evaluated using a multimodal questionnaire. A secondary analysis of patient experience regarding participation in the ERAS programme was conducted using a semistructured qualitative interview via telephone at 30-day follow-up.Results The mean patient satisfaction was significantly higher in the ERAS group than in the control group at discharge (92.2±4.3 vs 86.8±7.4, p=0.0001). The most important predictors of patient satisfaction included age (OR=6.934), postoperative nausea and vomiting (PONV) Visual Analogue Scale (VAS) score (OR=0.184), absorbable skin suture (OR=0.007) and postoperative length of stay (LOS) (OR=0.765). Analysis on patient experience revealed five themes: information transfer, professional support, shared responsibility and active participation, readiness for discharge, and follow-up, all of which are closely related and represent positive and negative aspects.Conclusions Measures that include decreasing PONV VAS score, incorporating absorbable skin suture and shortening LOS seem to increase patient satisfaction in a neurosurgical ERAS programme. Analysis of data on patient experience highlights several aspects to achieve patient-centred and high-quality care. Further studies are warranted to standardise the assessment of patient satisfaction and experience in planning, employing and appraising the ERAS programme.Trial registration number ChiCTR-INR-16009662.https://bmjopen.bmj.com/content/9/11/e028706.full
spellingShingle Lei Chen
Bolin Liu
Shujuan Liu
Yuan Wang
Binfang Zhao
Tianzhi Zhao
Lanfu Zhao
Wenhai Lv
Yufu Zhang
Tao Zheng
Yafei Xue
Long Chen
Yingxi Wu
Guodong Gao
Yan Qu
Shiming He
Neurosurgical enhanced recovery after surgery (ERAS) programme for elective craniotomies: are patients satisfied with their experiences? A quantitative and qualitative analysis
BMJ Open
title Neurosurgical enhanced recovery after surgery (ERAS) programme for elective craniotomies: are patients satisfied with their experiences? A quantitative and qualitative analysis
title_full Neurosurgical enhanced recovery after surgery (ERAS) programme for elective craniotomies: are patients satisfied with their experiences? A quantitative and qualitative analysis
title_fullStr Neurosurgical enhanced recovery after surgery (ERAS) programme for elective craniotomies: are patients satisfied with their experiences? A quantitative and qualitative analysis
title_full_unstemmed Neurosurgical enhanced recovery after surgery (ERAS) programme for elective craniotomies: are patients satisfied with their experiences? A quantitative and qualitative analysis
title_short Neurosurgical enhanced recovery after surgery (ERAS) programme for elective craniotomies: are patients satisfied with their experiences? A quantitative and qualitative analysis
title_sort neurosurgical enhanced recovery after surgery eras programme for elective craniotomies are patients satisfied with their experiences a quantitative and qualitative analysis
url https://bmjopen.bmj.com/content/9/11/e028706.full
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