Surgical neuro-oncology patient’s hospital discharge: improving the experience

Abstract

INTRODUCTION: The national cancer hospital in-patient experience survey 2015 identified unmet information needs for neuro-oncology patients regarding hospital discharge following surgery. To further understand what were the patient's specific concerns the neuro-oncology clinical nurse specialist (CNS) team at the National Hospital for Neurology and Neurosurgery (NHNN) undertook a short survey with the objective of introducing an intervention to improve patient experience. AIM: To identify the needs of brain tumour patients following hospital discharge from NHNN postsurgery. METHOD: Telephone survey. Patients identified between February- March 2016. Participants must have been discharged home following a craniotomy or biopsy of their brain tumour. A seven question qualitative questionnaire was developed from prior patient feedback. Patients received a telephone call from a member of the CNS team two weeks after discharge. All identified concerns were recorded and explored using an open approach. Responses were collated and analysed for key words and recurring themes. RESULTS: 24 patients identified within the time period. 22 discharged home; 1 transferred to a Neuro-rehab unit and 1 repatriated to a local hospital. Four main themes identified- pain and analgesia, future treatments wound care, and timing of discharge. CONCLUSION: We achieved our aim in identifying the needs of brain tumour patients following hospital discharge. We recognise that some of the patient suggestions are unable to be met e.g. receiving a diagnosis and treatment plan before discharge- this is due to the histopathology processing. RECOMMENDATIONS: Identified the need for improved patient information. A neuro-oncology specific discharge leaflet which can be provided to all brain tumour patients post-surgery will be created. Amend the discharge summary to include a comprehensive instruction of how/when to remove surgical clips/sutures for the patients GP practice. A discharge checklist to be implemented which is a brain tumour patient specific; as discussed with the senior nursing and surgical teams.