Redesigning Pre-surgery Patient Journeys With Telehealth

NCT05781789 | Active Not Recruiting DMC

• 1 other identifier: AM/HRT/008/2021
• Study Type: observational
• Target: 258
• Locations: 1 country
• Sites: 1

Brief Summary

Prior to surgery, patients undergo preanaesthesia assessment to ensure timely optimisation of medical conditions that could adversely impact perioperative outcomes. At the Preadmission Service (PAS) clinic of KK hospital, nurses perform the first triage to identify patients who require outpatient anaesthetic review in advance of surgery. While all elective patients attend the PAS clinic, only 8% are require outpatient anaesthetic review. The majority 92%, can be safely triaged to receive preanaesthesia assessment on the day of surgery. In this project, the investigators propose to investigate the efficacy of a new pre-surgery workflow for elective surgical patients incorporating telehealth. The investigators hypothesize that the redesigned pre-surgery journey incorporating telehealth reduces in-person consultation at the pre-admission clinic by up to 90%. Primary outcome is the proportion of eligible same-day-admission patients assessed via telehealth. Secondary outcomes are:

1. 1.Patient cost and time savings
2. 2.Patient experience of the new model of care
3. 3.Staff experience of the new workflow
4. 4.Incidence of day-of-surgery cancellations

Conditions

Surgery

Keywords

Preoperative evaluation; Telehealth

Outcome Measures

Primary Outcomes (1)

• Proportion of eligible elective surgery patients assessed successfully via telehealth for preoperative evaluation

  Of the total number of patients booked for elective surgery, the proportion of patients evaluated preoperatively by telehealth is measured.

  One year from the initiation of the implementation phase (Phase 3)

Secondary Outcomes (2)

• Patient's perception and attitude towards a Telehealth model of care for preoperative evaluation

  5 months from July to November 2021

• Healthcare providers' perception and attitude towards a Telehealth model of care for preoperative evaluation

  5 months from July to November 2021

Study Arms (2)

Patient participants

Patient booked for elective surgery and: Age 21 to 70 years English literacy Willing to provide signed consent Of any nationality Able to give own legal consent

Other: Telehealth for preoperative evaluation

Healthcare provider participants

Criteria: * Age 21 to 70 years * Healthcare professionals comprising clinic staff (surgical outpatient clinics, PAS), clinicians (anaesthetists, surgeons), and health service managers) * working in the perioperative clinical areas

Other: Telehealth for preoperative evaluation

Interventions

Telehealth for preoperative evaluation OTHER

Conduct of preoperative evaluation remotely using Zoom application

Also known as: Video consultation

Healthcare provider participants; Patient participants

Eligibility Criteria

• Age: 21 Years - 70 Years
• Gender Eligibility Details: Patient participants are female as they are recruited from a women's hospital
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Patient participants are female patients booked for elective surgery at a tertiary women's hospital. Healthcare participants are nurses, administrators, surgeons and anaesthetists working in the preoperative and surgeons' clinics at a tertiary women's hospital.

You may qualify if:

• Patient participants:
• Age 21 to 70 years Listed for elective surgery English literacy Willing to provide signed consent Of any nationality Able to give own legal consent

You may not qualify if:

• Healthcare participants:
• Age 21 to 70 years Healthcare professionals comprising clinic staff (surgical outpatient clinics, PAS), clinicians (anaesthetists, surgeons), and health service managers)

Sponsors & Collaborators

• KK Women's and Children's Hospital: lead
• Nanyang Technological University: collaborator
• Duke-NUS Graduate Medical School: collaborator

Study Sites (1)

KK Women's and Children's Hospital

Singapore, 229899, Singapore

Location

Related Publications (6)

• Wong DT, Kamming D, Salenieks ME, Go K, Kohm C, Chung F. Preadmission anesthesia consultation using telemedicine technology: a pilot study. Anesthesiology. 2004 Jun;100(6):1605-7. doi: 10.1097/00000542-200406000-00038. No abstract available.

  PMID: 15166585 RESULT

• Applegate RL 2nd, Gildea B, Patchin R, Rook JL, Wolford B, Nyirady J, Dawes TA, Faltys J, Ramsingh DS, Stier G. Telemedicine pre-anesthesia evaluation: a randomized pilot trial. Telemed J E Health. 2013 Mar;19(3):211-6. doi: 10.1089/tmj.2012.0132. Epub 2013 Feb 5.

  PMID: 23384334 RESULT

• Mullen-Fortino M, Rising KL, Duckworth J, Gwynn V, Sites FD, Hollander JE. Presurgical Assessment Using Telemedicine Technology: Impact on Efficiency, Effectiveness, and Patient Experience of Care. Telemed J E Health. 2019 Feb;25(2):137-142. doi: 10.1089/tmj.2017.0133. Epub 2018 Jul 26.

  PMID: 30048210 RESULT

• Murray E, Treweek S, Pope C, MacFarlane A, Ballini L, Dowrick C, Finch T, Kennedy A, Mair F, O'Donnell C, Ong BN, Rapley T, Rogers A, May C. Normalisation process theory: a framework for developing, evaluating and implementing complex interventions. BMC Med. 2010 Oct 20;8:63. doi: 10.1186/1741-7015-8-63.

  PMID: 20961442 RESULT

• Donelan K, Barreto EA, Sossong S, Michael C, Estrada JJ, Cohen AB, Wozniak J, Schwamm LH. Patient and clinician experiences with telehealth for patient follow-up care. Am J Manag Care. 2019 Jan;25(1):40-44.

  PMID: 30667610 RESULT

• Lew E, Tan SFJ, Teo A, Sng BL, Lum EPM. Perceptions and Attitudes of Patients and Health Care Stakeholders on Implementing a Telehealth Service for Preoperative Evaluation: A Qualitative Analysis. Telemed Rep. 2023 Jun 26;4(1):156-165. doi: 10.1089/tmr.2023.0023. eCollection 2023.

  PMID: 37771697 DERIVED

MeSH Terms

Interventions

Telemedicine

Intervention Hierarchy (Ancestors)

Delivery of Health Care; Patient Care Management; Health Services Administration

Study Officials

• Chai-Rick Soh, FANZCA

  Singapore General Hospital

  STUDY CHAIR

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER GOV
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: March 12, 2023
• First Posted: March 23, 2023
• Study Start: July 13, 2021
• Primary Completion: December 31, 2024
• Study Completion (Estimated): December 31, 2026
• Last Updated: April 18, 2025

Record last verified: 2025-03

Data Sharing

• IPD Sharing: Will not share

Locations

SG (1)