Transitional Care Program for Spine Surgery: Impact on Length of Stay for Extended Recovery Unit Patients

This study evaluates the effectiveness of a transitional care program (TCP) implemented for spinal neurosurgery patients, focusing on the reduction of length of stay (LOS).

We conducted a retrospective analysis of patients treated by 5 primary surgeons at our institution from January 2023 to December 2023. The analysis included 2 distinct parts: a multivariable ordinary least squares regression to determine factors affecting LOS for all spine surgery patients and a subset analysis using multivariable logistic regression to identify factors contributing to extended LOS in extended recovery unit (ERU)-admitted patients.

The study encompassed 986 patients, highlighting a significant reduction in LOS for those with planned ERU stays. Key findings from the ordinary least squares regression revealed factors such as chronic obstructive pulmonary disorder history and postoperative complications significantly increased LOS, whereas planned ERU admission decreased LOS. The logistic regression focused on ERU patients indicated that chronic obstructive pulmonary disorder markedly increased the odds of an extended LOS. However, receiving an educational visit from a TCP nurse significantly decreased the likelihood of extended LOS, underlining the importance of in-hospital education. In addition, complex surgeries indicated by the number of levels fused showed a correlation with prolonged LOS.

Our findings underscore the significance of targeted educational interventions and preoperative planning in achieving these outcomes. Future efforts should aim to further refine the TCP and explore digital innovations for patient engagement and education.