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An enhanced recovery programme for colorectal patients at Kettering General Hospital is helping people to get safely home after surgery sooner than ever before.

 And its shorter length-of-stays, and less patients needing intensive care treatments afterwards, mean its results are some of the best in the country.

 The winning formula has been established through a combination of dedicated pre and post operative care with the support of a ward team, along with the use of high-technology via a mobile phone app called PostOp developed at KGH.

 Elective Nurse Practitioner, Melanie Moore, said: “As a relatively small hospital, compared with many other large specialist hospitals, we are doing extraordinarily well.

 “Our length of stay for colorectal cancer surgery are on average four to five days. Comparable hospitals have stays averaging five to six days and some have stays as long as 11 days.

 “The reason we can enable our patients to go home so quickly is a combination of the way we prepare them for surgery, how we monitor and actively work with them after surgery, and how we use technology to stay in close touch with them throughout  their surgical journey which is very reassuring for the patient and helps prevent readmissions.”

 The Enhanced Recovery Programmes works by:

• Giving colorectal patients a comprehensive pre-operative assessment – which is at least an hour long - in the days or weeks before their operation. For colorectal cancer patients this allows significant tests to be performed including ECGs and tests on iron levels – which can be crucial in ensuring they are fit for surgery and able to recover quickly from it.
• The Geddington Ward surgical team consistently delivering a specific Enhanced Recovery Programme. This involves working with patients from the moment they come out of theatre and includes encourage them to walk right away, giving them a specific diet to help their stomachs to keep working, and actively educating and supporting them to have the confidence to go home,

 

•        Using a mobile phone Post Op app. This specialised enhanced recovery App enables patients to answer key questions about their recovery through mobile phone questionnaires as well as posting pictures and video of their wounds for doctors and nurses to study. It provides patients great reassurance their recovery is progressing and reduces the need for hospital follow-up appointments.

 Associate Specialist in Trauma and Orthopaedics, Mr Faizal Rayan, is one of the KGH team which included Consultant Orthopaedic Surgeon, Mr Hamidreza Khairandish, Infection Control Nurse Specialist, Sara Monteiro, and Elective Nurse Practitioner, Melanie Moore, who worked with IT experts to develop the PostOp app over the last three years.

 He said: “We developed an app which helps clinical teams to engage with patients about all aspects of their surgical journey from pre-operative assessment through to discharge and monitoring.

“This has combined with the way the team have developed the Enhanced Recovery Programme for complicated high-risk colorectal surgery patients in such an effective way that patients are able to go home early.

“They have looked at each stage of the patient’s journey, what causes delays, and done everything they can to minimise those delays and keep patients as fit as possible and ready to go home.”

Geddington Ward Sister Anna Patrick said: “What it really boils down to is that we are providing a package of enhanced recovery care that is one of the best in the country.

“We have a team who know what needs to be done and are dedicated to doing it so that patients get through their surgery as well as possible.

“We then help them walk, eat, and gain confidence so they can go home as soon as possible. They do this with the reassurance they get from continuing to be closely monitored by the surgical team through the PostOp app.”

Infection Control Nurse Specialist Sara Monteiro said: “It is important to monitor post-surgery wounds for 30 days because the antibiotics taken to prevent infection can sometimes mask an infection that can develop and cause problems.

 “We use the PostOp app to take a good look at how a wound is healing and either reassure the patient that everything is looking good or bring them in if there is something we need to investigate further.

 “I think part of our secret though is that we take such a personal interest in our patients and do everything we can to optimise their recovery.

 “We also have clinics where we can quickly address any problems so there is no need for patients to be readmitted.”

 The PostOp app achieved highly commended (second place) in the HSJ Digital Awards 2024 in the Digital pathways to Net Zero category. HSJ Digital Awards 2024: Moving Towards Net Zero Through Digital | HSJ Awards | Health Service Journal

 It also reached the finals in another award category for Supporting Elective Recovery through Digital.