HEAPS Study (Home Early After Pituitary Surgery): implementing an enhanced discharge protocol in transsphenoidal pituitary surgery
EANS Academy. Taysom H. 09/25/19; 275649; EP04049
Henry Taysom
Henry Taysom

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Introduction: Using the GIRFT (Getting It Right First Time) model we reviewed the KCH Pituitary service over the period 2016 - end of 2017. It showed increased Length of Stay (LoS) and Complication rate (CR) compared to the national average.
Aim: Characterising our patient group, identifying causes for the discrepancies and preparing for implementation of the Home Early After Pituitary Surgery (HEAPS) protocol.
Methods: Retrospective Cohort Study (September 2018-December 2018).
Results: The KCH Pituitary surgery service was shown to have a longer LoS (8 versus 6 days) and a higher (28% vs 19%) than the national averages. We identified 11 patients who would match our HEAPS criteria, representing a potential saving of 22 bed days. Our study showed an improvement on the CR (17%) and LoS (7d).
Further evaluation showed our NFPA (Non-Functioning Pituitary Adenomas) cohort represented longer stays, with more complications than other tumour types.
DI requiring DDAVP was the most common complication at 38%, followed by treatment of CSF leak with lumbar drains (17%), and open CSF leak repair (10%).
Conclusion: We have identified areas to improve and a substantial group of well patients who are remaining in hospital unnecessarily. The saving from the extra bed days would enable the hiring of a Pituitary CNS. We aim to implement our new protocol and re-audit in time for EANS.
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