New research calls for improvements in follow-up care for older people after surgery

Scientists at the University of Exeter and NIHR ARC South West Peninsula (PenARC) have published new research which could influence the management of hospital discharge for older people after surgery.

The report, funded by the National Institute for Health and Care Research (NIHR) is a comprehensive review, addressing gaps in knowledge around the impact of leaving hospital early after elective surgery for adults aged sixty or above.

Quicker patient turnaround times are one way of easing the burden on the NHS and reducing the risk of in-hospital complications such as falls or urinary infections. Previous research has found that leaving hospital earlier does not increase the risk of complications and readmission.

This research aimed to look in more detail at the implications of earlier discharge on patients and carers. Through two separate reviews of clinical and patient-reported outcomes and experiences, the researchers found that the best outcomes for older people usually happened when:

• They were asked about their quality of life and individual goals for recovery,
• Follow-up care included information on medication use, further treatment, and advice about where to seek support,
• Carers were involved in discharge plans and their concerns were considered,
• An individual approach to patients was taken, including a familiar contact, such as a nurse, taking the time to explain the patient’s treatment and answer questions,
• The patient was recognised as an active participant in their care, and as someone who can challenge themselves to achieve recovery targets and monitor their own progress, where feasible.

Dr Michael Nunns, lead researcher, said: “Efforts to reduce length of stay in hospital after planned surgery have made great strides in recent years. This project gave us an important understanding of factors valued by patients and carers.  However, many of the possible consequences that older adults and their families believe to be important following a stay in hospital have not been evaluated in research studies.

“More work is needed to confidently make statements about what older adults, carers and primary/community care services feel about leaving hospital earlier after planned surgery. This is an important area in terms of its implications for the wider context of health and social care in the UK.”