Addressing Perioperative Needs in Head and Neck Cancer: Piloting a Nurse Practitioner-Led Preoperative Virtual Visit

To improve understanding of the postoperative care challenges of patients with head and neck cancer and to help address these care needs before surgery.

Qualitative study with intervention development and process testing.

Tertiary care academic medical center.

To examine perioperative patient experiences, we first performed interviews of 28 adult patients with head and neck cancer undergoing resection with microvascular free flap reconstruction. We then developed a unique preoperative virtual visit focused on socioeconomic and perioperative needs. 50 visits were then conducted by advanced practice providers, and visit content was analyzed.

Before the new preoperative visit, 73% of patients did not plan for postoperative care preoperatively and 73% did not feel comfortable with postoperative care needs. 55% reported unaddressed socioeconomic hardship. Themes included: limited understanding of surgery and limited understanding of postoperative care needs. After the new preoperative visit, 62% of visits addressed significant care-related concerns not previously identified.

An additional preoperative virtual visit by an advanced practice provider may help improve surgical expectations and better prepare patients and their caregivers for perioperative needs.