Pooling and patient satisfaction in non-instrumented lumbar decompressive surgery.

Autor: Halliday J; a Department of Neurosurgery , Salford Royal NHS Foundation Trust , Salford , Manchester , United Kingdom of Great Britain and Northern Ireland., Holsgrove D; a Department of Neurosurgery , Salford Royal NHS Foundation Trust , Salford , Manchester , United Kingdom of Great Britain and Northern Ireland.
Jazyk: angličtina
Zdroj: British journal of neurosurgery [Br J Neurosurg] 2019 Feb; Vol. 33 (1), pp. 8-11. Date of Electronic Publication: 2018 Nov 19.
DOI: 10.1080/02688697.2018.1527014
Abstrakt: Objectives: To determine the effect of pooling of patients for elective non-instrumented lumbar decompression on patient satisfaction and waiting times.
Materials and Methods: We performed a retrospective review of Spine Tango and Theatre Databases of our Neurosurgical unit for patients who underwent elective primary non-instrumented lumbar decompression between January 2012 and 2016. Patient satisfaction scores at 3 and 12 months post-surgery were collected from the Spine Tango Registry, and patients categorised as pooled/non-pooled by searching theatre databases to determine their named listing and operating consultants. Results were analysed numerically and by performing chi-squared testing to determine if pooling affected patient satisfaction. Theatre records were analysed between January 2004-2006, January 2009-2011 and 2014-2016 to determine what effect implementation of the 18-week wait target system (2009) and of our pooled system (2012) had on waiting times to operation for patients undergoing elective primary non-instrumented lumbar decompression.
Results: There is no significant difference in patient satisfaction levels between pooled and non-pooled patients at 3 (p = .052) and 12 months (p = .5) post primary elective lumbar decompression (significance p < .05). There was no difference in average waiting time between the pooled and non-pooled groups. Both setting of 18-week targets and pooling improved waiting times. Setting of 18-week targets affected average waiting times markedly while pooling most notably reduced the variability in waiting times between patients for the same procedure.
Conclusions: Pooling of patients for elective non-instrumented lumbar decompression in our unit has improved waiting times, particularly the variability in them, with no detriment to patient satisfaction. We would recommend other units to consider developing a system of pooling such as ours, to help maximise use of their current resources and avoid highly variable waiting times for patients for the same procedure within the same department.
Databáze: MEDLINE
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