P2.07-010 Hospital Readmission Rates within 30 Days Following Thoracic Oncology Surgery: Topic: Research, Audits

Abstract

Readmission after thoracic surgery is not well documented. It impacts on patients’ physical and psychological wellbeing, whilst also increasing healthcare costs. The Thoracic Enhanced Recovery programme at Papworth Hospital (a regional cardio-thoracic centre) has reduced average length of stay from 12 days (2010) to 5 days (2014). The lung cancer nurse specialists (LCNS) were concerned that a shorter length of stay may increase the incidence of readmission. An audit was undertaken to determine the number of thoracic oncology surgical patients readmitted within 30-days of discharge. From 1st April 2015 to 31st July 2015 all surgical patients were contacted by a LCNS 30 days following discharge. A formic questionnaire including demographic, socioeconomic, surgical factors and readmission details (if appropriate) was completed. 74 patients underwent surgery, 68 (92%) completed the questionnaire. Of these 11 (16%) were never smokers, 45 (66%) ex-smokers, 12 (18%) current smokers. Lobectomy was the most common operation 45 (66%). Video-Assisted Thoracoscopy (VATS) accounted for 72% of all operations. 60/66 (91%) felt ready for discharge, 9/68 (13%) were discharged home with a pleural drainage system, 40/64 (63%) were aware to contact LCNS for advice. Average length of stay 6.6 days, thoracotomy 7.5 days, current smokers 9 days, patients readmitted 10 days. 30-day readmission rate was 13/68 (19%) of these 9 (69%) were readmitted within 7 days. Initially our concern was that a shorter length of stay may increase the incidence of readmission. However our findings showed that a longer length of stay (and current smoking status) was associated with an increased risk of readmission. This audit therefore suggests that enhanced recovery at Papworth Hospital is a safe and effective practice. Recommendations:•Review patient education / encourage patient self-referral for advice.•Improve discharge planning / communication with the community.•Establish a smoking cessation clinic / telephone service.•Implement a thoracoscore to accurately identify and target the highest risk patients.•Repeat audit over a longer period.