Implementation of remote patient monitoring to reduce gastrostomy tube resource utilization

To reduce unnecessary healthcare utilization, enhance perioperative support, and improve the family experience related to gastrostomy tube (G-tube) care, we implemented a remote patient monitoring (RPM) program.

In September 2023, all ambulatory patients scheduled for a G-tube were eligible to enroll in the RPM program, a 6-month quality improvement intervention providing support before and after surgery through just-in-time education, questionnaires, and check-ins. Electronic health record data for ambulatory pediatric patients who had G-tubes placed by general surgery at a single institution 18 months pre- and post-intervention (March 2022-February 2025) was retrospectively reviewed. The SMART aim was to reduce emergency department (ED) and clinic revisits related to new G-tubes by 50 % within 90-days following surgery.

A total of 440 patients were included. Of the 207 eligible patients, 146 (70.5 %) enrolled or completed the RPM program. Propensity score matching was utilized to account for differences in patient demographics and characteristics between RPM and non-RPM cohorts. ED visits related to G-tubes within 90 days following placement were reduced by 48 % (11.0 % in RPM participants vs. 21.0 % in nonparticipants, p = 0.02). Overall G-tube related ED revisits were 48 % lower in the RPM group (14.0 % in RPM participants vs. 26.0 % overall in nonparticipants p = 0.04). Clinic revisits and calls related to G-tubes did not significantly differ.

Early results demonstrate RPM programs are an effective method to proactively identify, support, and address education gaps; reinforce key components of care; increase care team engagement; and encourage early communication.