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The investigators are conducting a prospective study to evaluate the SKH@Home programme, a post-discharge monitoring initiative for surgical patients. The aim of this study is to conduct a pragmatic, non-randomized pilot study to compare the SKH@Home programme with standard post-surgical care on patient outcomes.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Standard inpatient care until deemed suitable for discharge | Active Comparator | Post-surgical patients are routinely monitored in the acute hospital setting, until they are deemed suitable for discharge by their primary surgeon. |
|
| Early post-surgical discharge with post-surgical home based monitoring | Experimental | The SKH@home program, is a post-discharge monitoring program, which allows stable post-surgical patients (after minimally invasive/ endoscopic/ bariatric surgery) or with stable surgical conditions after interventions (like abdominal or liver abscess management) to be discharged earlier from the acute hospital while providing regular post-discharge monitoring at the patient's own home, either through home visits or patient assessment via telemonitoring. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Early post-surgical discharge with post-surgical home based monitoring | Procedure | The SKH@home program, is a post-discharge monitoring program, which allows stable post-surgical patients to be discharged earlier from hospital while providing regular post-discharge monitoring at the patient's own home, either through home visits and patient assessment, or telemonitoring of patients. |
| Measure | Description | Time Frame |
|---|---|---|
| Bed days saved | Bed days saved in the acute hospital setting | From enrollment to 30 days after patient is discharged from the hospital/ post-discharge monitoring programme |
| Return to hospital | Unplanned readmission/ return to the hospital within 30-days | From enrollment until 30-days after patient is discharged from the hospital/ from post-discharge monitoring care |
| Length of stay | Combined length of stay. For inpatients, will be time of admission till time of discharge from acute hospital For patients enrolled into post-discharge monitoring programme, will be from time of admission till time of discharge from post-discharge monitoring programme | From enrollment until patient is discharged from the hospital/ from post-discharge monitoring care (up to around 2 weeks), whichever is longer |
| Hospitalisation bill | Total non-subsidised hospitalisation bill size | From enrollment until 30-days after patient is discharged from the hospital/ from post-discharge monitoring care |
| Postoperative complications | 30-day postoperative complications, graded by the Clavien-Dindo classification | From enrollment until 30-days after patient is discharged from the hospital/ from post-discharge monitoring care |
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Inclusion Criteria:
Patient is keen for home management
Hemodynamically stable
Able and willing to self-care and monitor / Good social support
Lives in Singapore's Northeast region
EITHER
Diagnosed with intra-abdominal abscess requiring ongoing IV antibiotics as recommended by Infectious Diseases Specialist where necessary OR Diagnosed with liver abscess requiring ongoing IV antibiotics as recommended by Infectious Diseases Specialist where necessary AND Has undergone initial treatment (e.g., drainage if required) and is clinically improving
OR
Underwent an uneventful straightforward bariatric surgical procedure, and has been monitored overnight without any immediate postoperative issues OR Underwent uneventful straightforward laparoscopic/ endoscopic/ minimally invasive surgery, and has been monitored for at least 6 hours without any immediate postoperative issues AND has no significant intraprocedural concerns by the operating surgeon
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Chui Kwan Mok | Contact | +65 69302747 | mok.chui.kwan@skh.com.sg |
| Name | Affiliation | Role |
|---|---|---|
| Koy Min Chue | Sengkang General Hospital | Principal Investigator |
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| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 34593374 | Result | McGillion MH, Parlow J, Borges FK, Marcucci M, Jacka M, Adili A, Lalu MM, Ouellette C, Bird M, Ofori S, Roshanov PS, Patel A, Yang H, O'Leary S, Tandon V, Hamilton GM, Mrkobrada M, Conen D, Harvey V, Lounsbury J, Mian R, Bangdiwala SI, Arellano R, Scott T, Guyatt GH, Gao P, Graham M, Nenshi R, Forster AJ, Nagappa M, Levesque K, Marosi K, Chaudhry S, Haider S, Deuchar L, LeBlanc B, McCartney CJL, Schemitsch EH, Vincent J, Pettit SM, DuMerton D, Paulin AD, Simunovic M, Williams DC, Halman S, Harlock J, Meyer RM, Taylor DA, Shanthanna H, Schlachta CM, Parry N, Pichora DR, Yousuf H, Peter E, Lamy A, Petch J, Moloo H, Sehmbi H, Waggott M, Shelley J, Belley-Cote EP, Devereaux PJ; PVC-RAM-1 Investigators. Post-discharge after surgery Virtual Care with Remote Automated Monitoring-1 (PVC-RAM-1) technology versus standard care: randomised controlled trial. BMJ. 2021 Sep 30;374:n2209. doi: 10.1136/bmj.n2209. | |
| 27016900 |
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| ID | Term |
|---|---|
| D018784 | Abdominal Abscess |
| D008100 | Liver Abscess |
| ID | Term |
|---|---|
| D000038 | Abscess |
| D013492 | Suppuration |
| D007239 | Infections |
| D008107 | Liver Diseases |
| D004066 |
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| ID | Term |
|---|---|
| D004322 | Drainage |
| ID | Term |
|---|---|
| D013812 | Therapeutics |
| D013514 | Surgical Procedures, Operative |
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|
| Standard inpatient care until deemed suitable for discharge | Procedure | Patients will receive standard postoperative management in the acute hospital until they are deemed fit for discharge by their primary surgeon |
|
| Result |
| Gunter RL, Chouinard S, Fernandes-Taylor S, Wiseman JT, Clarkson S, Bennett K, Greenberg CC, Kent KC. Current Use of Telemedicine for Post-Discharge Surgical Care: A Systematic Review. J Am Coll Surg. 2016 May;222(5):915-27. doi: 10.1016/j.jamcollsurg.2016.01.062. Epub 2016 Feb 13. No abstract available. |
| 33641013 | Result | Jonker LT, Lahr MMH, Oonk MHM, de Bock GH, van Leeuwen BL. Post-discharge Telemonitoring of Physical Activity, Vital Signs, and Patient-Reported Symptoms in Older Patients Undergoing Cancer Surgery. Ann Surg Oncol. 2021 Oct;28(11):6512-6522. doi: 10.1245/s10434-021-09707-3. Epub 2021 Feb 27. |
| 36812167 | Result | van Ede ES, Scheerhoorn J, Buise MP, Bouwman RA, Nienhuijs SW. Telemonitoring for perioperative care of outpatient bariatric surgery: Preference-based randomized clinical trial. PLoS One. 2023 Feb 22;18(2):e0281992. doi: 10.1371/journal.pone.0281992. eCollection 2023. |
| 39028346 | Result | Cooper S, Patel S, Wynn M, Provost D, Hassan M. Outcomes of same-day discharge in bariatric surgery. Surg Endosc. 2024 Sep;38(9):5122-5129. doi: 10.1007/s00464-024-11053-w. Epub 2024 Jul 19. |
| Digestive System Diseases |