Developing and evaluating Robocare; an innovative, nurse-led robotic prostatectomy care pathway

Area of Science:

• Urology
• Surgical Oncology
• Health Services Research

Background:

• Robotic-assisted radical prostatectomy (RARP) is a common treatment for prostate cancer.
• Effective patient preparation and post-operative management are crucial for optimal outcomes.
• Multidisciplinary care pathways can enhance patient support and streamline healthcare delivery.

Purpose of the Study:

• To establish and assess the safety and efficacy of the Robotic Prostatectomy Care Pathway (Robocare).
• To evaluate patient satisfaction, interdisciplinary care coordination, length of stay, and readmission rates associated with the Robocare pathway.
• To determine the impact of a multidisciplinary, nurse-led approach on patient recovery and hospital resource utilization.

Main Methods:

• Analysis of a database of patients undergoing RARP within the Robocare pathway at Peter MacCallum Cancer Centre (July 2012 - December 2013).
• Evaluation of compliance, length of stay, and postoperative course.
• Assessment of patient satisfaction through surveys and analysis of complication management and referrals.

Main Results:

• High discharge rate: 85% of 124 patients discharged on day 1 post-op (mean stay 1.3 days).
• Extensive support: >95% received post-op calls; 60% utilized long-term follow-up clinic.
• Effective complication management: 66% of 29 complications resolved by nurse specialists.
• High patient satisfaction: 96% of surveyed patients (n=74) reported being well/very well supported.
• Significant referrals: 18 psychologist, 44 sexual health, 44 physiotherapy referrals.

Conclusions:

• The Robocare pathway is a safe and effective model for RARP patients.
• High patient satisfaction and effective management of side effects were observed.
• The pathway contributes to reduced length of stay, lower readmission rates, and efficient outpatient follow-up.
• A nurse-led, multidisciplinary approach appears to improve care, outcomes, and hospital resource management for RARP patients.