Decision regret is low for same-day discharge of patients undergoing RARP

In this video, David I. Lee, MD, FACS, discusses the AUA 2024 abstract, “Decision regret of discharge pathway choice among robot-assisted radical prostatectomy patients.” Lee is director of the UCI Health Comprehensive Prostate Cancer Program and professor of urology at the UCI School of Medicine.

Transcription:

Please give an overview of the AUA 2024 presentation "Decision regret of discharge pathway choice among robot-assisted radical prostatectomy patients."

We at UCI have been doing a lot with facilitating quicker recovery and really acceptable patient pathways for our radical prostatectomy patients that we do robotically. One of the things that we found is really appealing for patients is the ability to be able to go home the same day rather than to be in the hospital overnight. I've done almost 7000 robotic prostatectomy cases now, and for a long time, we've kept the patients overnight. And looking at our long experience, very few things ever happened to patients when they stayed overnight, meaning they needed any kind of intervention. I'd see the guys the next morning, and they'd be looking great. We started thinking, why can't we send these guys home the same day? So then, we worked with our anesthesia team to develop a pathway that would work well for patients. And then we started doing this and sending patients home the same day. Very few patients wanted to do this at the beginning, but then what happened was COVID, and so our hospital shut down. We couldn't do cases in the operating room. But then we had worked out this pathway, and so when the hospital wanted to reinstitute cases and not have patients stay, we were able to take care of these prostate cancer patients and actually send them home the same day. And then so once we reinstituted our cases, we were able to immediately send 70% of our patients home the same day. Once I came to UCI, about 3 years ago now, we've been sending 95% of our patients home the same day. And so in order to look at this a little bit more carefully, we looked at our patient satisfaction and looked at their perspective on regret of their choice that they made of when they chose to go home. There have been different studies looking at this concept of patient regret with care decisions. Our data showed that the patient regret scores were very, very low in looking at the patients that went home the same day. I think this was very important to look at because certainly, you could send patients home the same day, and then you don't hear from them, but you don't know how happy they are with their choice. They could be at home but suffering a lot and not feeling good. And even though they can safely go home, they may not be happy with that. So then we did a questionnaire-based analysis of our patients' perspectives and found that they are actually very quite happy going home the same day. So it makes us feel really good about continuing to offer this and refine this pathway.

This transcription was edited for clarity.