Promoting Postdischarge Telephone Follow-Up of patients with Transurethral Resection for Bladder Cancer: a best practice implementation project

Abstract

It is known that many patients who have undergone TURBT bladder surgery face various problems in the first weeks after being discharged from the hospital. Telephone follow-up (TFU) is considered as an effective means to exchange information, provide health education and counseling, manage symptoms, detect early complications, provide reassurance and provide quality care after hospitalization. Shorter hospital stays lead to fewer opportunities to counsel patients and address their concerns. In addition, most complications occur at home.therefore, follow-up after discharge is necessary for patients and their relatives to prepare for self-care and lifestyle changes. This study is designed as a clinical audit to improve TFU. Methods: This evidence implementation project used the JBI Evidence Implementation framework. A clinical audit was undertaken using the JBI Practical Application of Clinical Evidence System (JBI PACES) tool. Two audit criteria, representing the best practice recommendations for promoting post-discharge telephone follow-up in the urology department were used. A baseline audit was conducted, followed by the implementation of multiple strategies. The project was finalized with a follow-up audit to evaluate changes in practice. Results: The aggregated data collated from the urology ward demonstrated that all of the criteria had achieved zero scores of compliances in the baseline audit round. The results of the GRiP process identified the main barriers to evidence implementation, and combated with strategies such as patient education about TFU, educational pamphlets preparation according to the latest validated guidelines, and a mobile app for education material about bladder cancer, diagnosis, management, and follow up. The Phase 3 follow-up showed an 88% increase in compliance with staff education about the post-discharge TFU as a component of comprehensive discharge planning, and a 22% achievement of patient follow-up by telephone soon.