Enhanced Recovery After Urogynecologic Surgery: A Survey of Patient Experience.

Abstract

The aim of this study was to identify which aspects/components of the enhanced recovery program (ERP) were associated with a positive patient surgical experience for patients undergoing urogynecologic surgery. A total of 198 patients who underwent pelvic reconstructive surgery requiring hospital admission were invited to complete questionnaires modeled after the validated Consumer Assessment of Healthcare Providers and Systems Surgical Care Survey patient experience survey. Patients were asked about 3 phases of ERP interventions: (1) before surgery (patient education, carbohydrate loading), (2) during the hospital stay (pain control, nausea, early ambulation), and (3) after discharge (return of bladder and bowel function). One hundred patients completed the survey (51% response rate). Greater than 90% of patients rated their overall surgical experience favorably (≥8 on 1-10 scale) regardless of age (P = 0.98), race (P = 0.26), education level (P = 0.12), perception of overall health (P = 0.17), or number of prior surgical procedures (P = 0.86). Ninety-two percent of patients reported that preoperative teaching about surgery was "very helpful," and specifically 90% reported that the ERP educational handbook was useful. Patients who reported a poor perception of their overall mental health were more likely to rate their surgical experience less favorably (<8 on 1-10 scale; P = 0.01), as were patients who left the hospital with a Foley catheter (P = 0.03). Greater than 90% of women surveyed who rated undergoing inpatient pelvic reconstructive surgery positively perceived their surgical experience within the ERP. The majority of patients who had a positive perception of the perioperative experience found the preoperative patient education useful.