The Effectiveness of a Criteria-Led Discharge Initiative on the Length of Stay of Patients Who Underwent a Robotic-Assisted Laparoscopic Prostatectomy
Abstract
Objectives To determine the impact of a criteria-led discharge initiative (CLD) on the hospital length of stay of
patients undergoing a robotic-assisted laparoscopic prostatectomy (RALP).
Methods This is a cohort study of prospectively collected data completed at a major tertiary hospital from December
2017 to August 2020. The CLD initiative consists of 4 criteria: clinical haemodynamic stability (heart rate < 100 beats/
minute, systolic blood pressure > 100mmHg), a drain output of less than 50 mL, flatulence or bowel movement, and
the ability to tolerate an oral diet. The primary outcome was hospital length of stay for patients before and after the
introduction of CLD.
Results One hundred men undergoing RALP before the implementation of the CLD initiative were compared to
118 men undergoing RALP following the implementation of CLD. The patients had similar baseline demographic
features. There was a significant difference found in hospital LOS with the pre-CLD group LOS (mean = 1.8 days,
SE = 0.12) being longer than the LOS in the post-CLD group (mean = 1.4 days, SE = 0.09, P = 0.015). There were no
significant between-group differences in the proportion of patients discharged on the first postoperative day and the
30-day readmission rate.
Conclusion Within our study population, we have demonstrated that the introduction of CLD was associated with
reduced hospital LOS with no increase in adverse events. These findings support the need for the development of CLD
in other conditions.
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