ATLANTA, GA USA (UroToday) - This is a ground breaking study, conducted in London, and presented at the AUA, evaluating the efficacy and economic benefits of a group intervention for surgical preparation.
Men undergoing radical prostatectomy and their partners require counseling about radical prostatectomy and its functional outcomes. We hear from patients and their partners that they experience limited, if any, counseling on the potential postoperative effects of continence and sexual function in the United States.
In this study, urology clinical nurse specialists delivered three PowerPoint presentations on continence management, erectile dysfunction and early complications to a group of patients and partners. Time was available for questions and peer-group discussion. Participant satisfaction was assessed with an anonymous questionnaire using Likert items. The use of a postoperative, open access, nurse-led telephone consultation service was also measured. The cost to the primary care trusts (PCTs) and number of nursing hours saved was compared between the group seminars and the traditional individual consultation model.
They had 360 patients and 294 partners participate in the seminars over a 12-month time period. Pre-seminar questionnaires indicated that only 23 patients felt prepared for surgery prior to the seminar. Following the seminar, all participants reported that they had received adequate information to deal with complications of surgery, and all stated a preference to a group seminar rather than individual consultations. Only one patient felt uncomfortable asking questions in a group.
Over 12 months, 30 nursing hours were required to deliver the seminars. To deliver the same education in one-to-one sessions, 540 specialist nursing hours (assuming 90 minutes per patient) would have been required.
They also conducted a cost comparison of individual one-on-one consultation to the group seminars described above demonstrating that the hospital saved £64,800 with a saving of 510 nursing hours to the hospital.
They also then assessed the potential revenue based on the 510 hours of nursing time. Savings was calculated as 170 potential clinics, with 8 patients seen in each 3 hour clinic (1360 patients). Potential revenue was calculated to be £122,400.
In the year prior to the seminar sessions, an average of 24 telephone calls were made by patients each month requesting additional information following radical prostatectomy. Since the introduction of the seminar sessions this has reduced to 6 calls, a 75% decrease in call volume. This may indicate that these patients and their partners received the information they needed prior to the surgical procedure, which may also reduce their overall anxiety.
This is a model worth considering for large group practices in the US, since they found that the group seminars are a feasible modality for preparing patients for surgery with effective delivery of information to patients and partners that exceeds individual consultations. It provides the immediate benefit of peer-support and is economical to both primary and secondary care providers.
Presented by Kinsella Janette, Anna Ashfield, Anna Ashfield, Hazell Elaine, Ben Challacombe, Rick Popert, and Declan Cahill at the American Urological Association (AUA) Annual Meeting - May 19 - 23, 2012 - Georgia World Congress Center - Atlanta, GA USA
