Patient Engagement With an Electronic Patient-Reported Outcomes Tool Evaluating Hospital Discharge Readiness After Cancer Surgery
Jennifer R. Cracchiolo, Richard S. Matulewicz, Norma E. Farrow, Marc A. Cohen, Michael Hannon, Daniela Molena, Iris Wei, Sigrid Carlsson, Thomas Atkinson, Melissa Assel, Andrew Vickers, Ginger J. Gardner, Deborah Schrag, Jamie OstroffPURPOSE
Patients undergoing cancer surgery often face complex, multidisciplinary needs related to recovery and discharge. The aim of this study was to develop and assess the adoption of an electronic patient-reported outcomes (ePRO) tool, Goals to Discharge (G2D), to improve discharge planning and recovery following colorectal and thoracic cancer surgeries.
METHODS
We developed the G2D tool using a mixed-methods approach incorporating feedback from patients, clinicians, and stakeholders. Survey items were selected through a stepwise process aligned with Enhanced Recovery After Surgery pathways. Hospitalized patients recovering from colorectal or thoracic surgeries at a tertiary cancer center were prompted to complete the G2D tool on postoperative day 1 until discharge. Adoption factors were analyzed for associations with patient engagement and postoperative length of stay (LOS).
RESULTS
Among 3,878 patients, the G2D tool had an adoption rate of 31% (1,190 patients with at least 1 survey response). Factors such as age, American Society of Anesthesia (ASA) score, primary language, and prolonged recovery room stays influenced adoption. Respondents to the G2D tool had a 3.7% reduction in the risk of prolonged LOS compared with nonrespondents ([95% CI, 0.84 to 6.5];
CONCLUSION
The G2D ePRO tool enhanced communication between patients and clinical teams, contributing to improved discharge planning and recovery. Respondents to the tool had a significantly lower risk of prolonged hospital stays after surgery. Further research is needed to refine digital discharge tools and explore strategies for optimizing recovery preparation.