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Patients undergoing total laryngectomy are at high risk for 30-day unplanned readmission. Many of these readmissions are related to stomal care, and it is thought that the readmissions could be prevented with better patient and caregiver education. The investigators are studying the effect of a comprehensive perioperative education program on 30-day unplanned readmission for patients undergoing total laryngectomy.
The comprehensive perioperative education program will include the following additional interventions:
-Preoperative visit with the speech pathologist for explanation of laryngectomy physiology, stomal education, and alaryngeal voice rehabilitation. Participants will be expected to undergo this intervention and to attend it with their "laryngectomy coach" (a family member or friend to accompany the patient through the education process), but failure to meet with the speech pathologist will not exclude a patient from the study.
This study will follow patients prospectively from the time of study commencement and then assess changes in patient knowledge before and after the education intervention. It will also compare rate of stomal complications and readmission rates to institutional historical averages to assess improvement in quality care.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Arm 1 | Experimental |
|
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Demographics and Health History Questionnaire | Other |
| ||
| Pre-Class Laryngectomy Survey |
| Measure | Description | Time Frame |
|---|---|---|
| Rate of 30-day unplanned readmission | -Calculate and report the rates of readmission for the patients undergoing the comprehensive laryngectomy education and compare to the rates of unplanned readmission and postoperative complications from historical cohorts at our institution. | 30 days after hospital discharge (approximately 7 weeks after registration) |
| Rate of postoperative complications | -Calculate and report the rates of readmission for the patients undergoing the comprehensive laryngectomy education and compare to the rates of unplanned readmission and postoperative complications from historical cohorts at our institution. | 30 days after hospital discharge (approximately 7 weeks after registration) |
| Change in patient's knowledge about total laryngectomy | -The change in knowledge due to the educational intervention will be measured using a within subject comparison of patient pre- and post-education test scores (e.g. each patient's post-education scores minus preeducation scores). | 30 days after hospital discharge (approximately 7 weeks after registration) |
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Inclusion Criteria:
Exclusion Criteria:
-none
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| Name | Affiliation | Role |
|---|---|---|
| Brian Nussenbaum, M.D. | Washington University School of Medicine | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Washington University School of Medicine | St Louis | Missouri | 63110 | United States |
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| Label | URL |
|---|---|
| Alvin J. Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine | View source |
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| Other |
|
| Counseling session with speech pathologist | Behavioral |
|
| Total Laryngectomy Preoperative Education Class | Behavioral |
|
| Day of Hospital Discharge Laryngectomy Survey | Other |
|
| Day of Discharge Practicum | Other |
|
| Laryngectomy Education Study Exit Survey | Other |
|
| ID | Term |
|---|---|
| D003710 | Demography |
| ID | Term |
|---|---|
| D011154 | Population Characteristics |
| D015991 | Epidemiologic Measurements |
| D011634 | Public Health |
| D004778 | Environment and Public Health |
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