This proposal describes a human subjects research study evaluating mHealth Ambulatory Surgery with Follow-up Nurse (Recovery@Home), as an alternative postoperative care pathway for selected low-acuity surgical procedures in Uganda. The Recovery@Home model discharges eligible patients home on the day of surgery and provides structured postoperative follow-up through nurse telephone calls, home visits, mobile-app documentation, escalation algorithms, and surgeon teleconsultation when clinically indicated. The proposed research includes a design to evaluate Recovery@Home against traditional postoperative inpatient care in a randomized controlled trial across three participating Ugandan surgical facilities.
Surgeries in high-income countries have progressively transitioned to ambulatory settings, but in low- and middle-income countries, even patients who have low-acuity surgeries still typically stay in the hospital after their surgeries, and these postoperative inpatient stays are costly and inefficient, for both patients and the surgical facilities. We propose an innovative approach of Recover@Home in Uganda, incorporating mobile technology into postoperative care, to ensure safe, cost-effective and efficient care with same-day discharge and reliable follow-up after surgery. Using a multicenter, randomized controlled trial, we will provide the evidence necessary to shift practice towards ambulatory surgery for low-acuity surgical procedures, resulting in more efficient and effective allocation of healthcare resources in LMICs.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
194
The Recovery@Home model discharges eligible patients home on the day of surgery and provides structured postoperative follow-up through nurse telephone calls, home visits, mobile-app documentation, escalation algorithms, and surgeon teleconsultation when clinically indicated.
Kyabirwa Surgical Center
Jinja, Uganda, Uganda
Hope and Healing Center
Iganga, Uganda
Lubaga Hospital
Kampala, Uganda
Mengo Hospital
Kampala, Uganda
Occurrence of any postoperative complication within 30 days
Occurrence of any postoperative complication within 30 days-will be treated as a binary variable (1 = complication, 0 = no complication).
Time frame: postoperative day 1, postoperative day 3, postoperative day 7, postoperative day 10, postoperative day 14, postoperative day 30
Financial cost to the patient
Indirect and direct costs to the patient
Time frame: end of study, at one month
Facility cost
facility costs includes building maintenance cost, personnel cost, material/equipment cost
Time frame: end of study, at one month
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