UTHealth program results in happier patients, lower costs in esophageal surgery

December 18, 2013

HOUSTON - (Dec. 18, 2013) - A new program designed to increase the overall satisfaction of patients undergoing esophageal surgery has resulted in lower patient costs and reduced times on both the operating table and in the hospital.

Led by The University of Texas Health Science Center at Houston (UTHealth) and Memorial Hermann Southeast Esophageal Disease Center, the study's results were published in this month's issue of the American Journal of Surgery.

"We wanted to perform cases more efficiently while still providing the highest levels of patient care," said lead author Farzaneh Banki, M.D., director of the Esophageal Disease Center and associate professor of cardiothoracic and vascular surgery at the UTHealth Medical School.

"Achieving higher patient satisfaction and decreased costs is the result of what can be accomplished with the power of a coordinated team."

UTHealth President Giuseppe Colasurdo, M.D., said the study is just one example of how the faculty and staff of UTHealth and Memorial Hermann are working together to improve care and quality for patients. "Modern health care involves teams of experts working together to manage not just diseases and symptoms, but the patient's overall health," he said.

"This study shows the importance of communication, education and teamwork in delivering the very best outcomes."

To make esophageal procedures more efficient, Banki built a team comprised of leaders in nursing, physical therapy, respiratory therapy, radiology, endoscopy, nutrition services and the operating room. The team meets each Wednesday to review surgical cases and identify special needs.

"Everybody's opinion matters in these meetings," Banki said. "From the surgeon's standpoint, everything flows so that when we get to the operating room, all we have to do is focus on the patient."

The team emphasizes staff education with monthly interactive educational sessions for hospital nurses and educational material for the operating room staff.

Fact sheets and other easy-to-understand information are provided to patients, who are carefully monitored by the surgical team and nursing staff after the surgery. A nutritionist meets with patients on the day of surgery to review their diets and answer questions. Clear discharge instructions are prepared, and Banki asks each patient to read them aloud to ensure they are understood.

The study measured differences before and after the program went into effect on Oct. 1, 2010. Banki and her team reported that the operating room time dropped from 185 minutes to 126; length of stay from 2 days to 1 day; operating room costs from $2,407 to $2,147; and hospital room costs from $937 to $556. At the same time, there were significant improvements in patients' experiences communicating with nurses, pain management, communication about medications and discharge instructions.

"When patients know that everyone on the team truly cares for them, I believe it helps in the healing process because they feel a sense of protection and confidence in their care," says Banki, who sees patients through UT Physicians, the medical group practice of the UTHealth Medical School.
-end-
The title of the study is "A surgical team with focus on staff education in a community hospital improves outcomes, costs and patient satisfaction."

Co-authors include Kelly Ochoa, R.N.; and Mary E. Carrillo, R.N., B.S.N., C.V.R.N. of the Memorial Hermann Esophageal Disease Center; and Samuel Leake, B.Sc.; Anthony Estrera, M.D.; Kamal Khalil, M.D.; and Hazim J. Safi, M.D., of UTHealth.

University of Texas Health Science Center at Houston

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