Our urology team have revolutionised the care we provide to our prostatectomy patients, with some patients now able to return home on the same day as their procedure.
The changes mean a better experience for prostatectomy patients, better outcomes and reduced pressure on surgical beds.
For a day prostatectomy, the patient arrives at 7am to be consented and clerked. Utilising the trust’s prostatectomy robot, the procedure starts at around 9am and normally lasts a little over three hours. The patient rests in the recovery room for about 90 minutes before being transferred onto a ward for the remainder of the day. Another 90 minutes later, after a light meal, the patient is mobilised and – if they are recovering from their operation as expected – discharged home at 7pm. The team check in with the patient later that evening around 10pm, and again at 8am next morning, to ensure that they are well.
“The important aspect of developing this care pathway has been keeping the patient safe,” explains Mr Edward Calleja, one of the team behind the new model. “Doing that was a big task for our team; it meant collaborating to change the way that we work, to ensure that we were able to move quickly and early with patients. It also meant then keeping on top of the patient’s recovery during the day and into the evening, after they are discharged. Making sure that we were able to provide that clinical oversight of the patient post-op outside of the hospital has been one of the key aspects we had to work hard to get right, but the feedback from patients has been really positive.”
Day case prostatectomies aren’t suitable for everyone; the patient needs to have good general health, a positive attitude towards recovery and will only be considered if the prostate cancer removal does not involve lymph node removal. If a patient does not fit that criteria and needs an overnight hospital stay after their operation then the team will continue to provide that support. But being discharged on the day of their operation means that day case patients can rest and recuperate in the peace and comfort of their own home, rather than on a busy hospital ward – and they have ‘open access’ to hospital follow-up care, meaning they can go straight onto a ward if they need more clinical support in their recovery.
“I’m really proud of all of my colleagues and how they’ve come together to deliver this new way of working,” says Edward. “The benefits it has delivered to patient wellbeing and experience have been significant, and it’s something we can potentially look at trialling in other surgical services. I’m proud that we’ve been able to develop this service and play our part in giving our communities the surgical services that they deserve.”