Post-discharge Monitoring Initiative on Outcomes of Post-surgical Patients

NCT06980402 | Not Yet Recruiting DMC

• 1 other identifier: 2024-4580
• Study Type: interventional
• Target: 1,000
• Locations: 0 countries
• Sites: N/A

Brief Summary

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.

Conditions

Laparoscopy; Discharge Planning

Keywords

Bariatric surgery; Laparoscopic surgery; Abdominal abscesses; Liver abscesses; Discharge planning

Outcome Measures

Primary Outcomes (5)

• 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

Study Arms (2)

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.

Procedure: Standard inpatient care until deemed suitable for discharge

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.

Procedure: Early post-surgical discharge with post-surgical home based monitoring

Interventions

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.

Early post-surgical discharge with post-surgical home based monitoring

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

Standard inpatient care until deemed suitable for discharge

Eligibility Criteria

• Age: 21 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• 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
• 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

You may not qualify if:

• Unable to self-care / no caregiver
• Requires daily review by the surgical team
• Suspicion of surgical complications requiring surgical intervention
• Requires post-discharge monitoring care for \> 2 weeks
• Unregulated psychiatric disorders
• Daily flushing of drains required

Sponsors & Collaborators

• Sengkang General Hospital: lead

Related Publications (5)

• 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.

  PMID: 34593374 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.

  PMID: 27016900 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.

  PMID: 33641013 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.

  PMID: 36812167 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.

  PMID: 39028346 RESULT

MeSH Terms

Conditions

Abdominal Abscess; Liver Abscess

Interventions

Drainage

Condition Hierarchy (Ancestors)

Abscess; Suppuration; Infections; Liver Diseases; Digestive System Diseases

Intervention Hierarchy (Ancestors)

Therapeutics; Surgical Procedures, Operative

Study Officials

• Koy Min Chue

  Sengkang General Hospital

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Chui Kwan Mok

CONTACT

+65 69302747; mok.chui.kwan@skh.com.sg

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NON RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Consultant, Clinical Assistant Professor, Department of General Surgery

Study Record Dates

• First Submitted: February 20, 2025
• First Posted: May 20, 2025
• Study Start: June 1, 2025
• Primary Completion (Estimated): December 31, 2028
• Study Completion (Estimated): January 31, 2029
• Last Updated: May 20, 2025

Record last verified: 2025-05