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A Multicenter Randomized Assessment of Patient Outcomes and Satisfaction

Lars M. Ellison, MD; Mike Nguyen, MD; Michael D. Fabrizio, MD; Ann Soh, MD; Sompol Permpongkosol, MD; Louis R. Kavoussi, MD

Arch Surg. 2007;142(12):1177-1181.

Hypothesis  Patient safety and satisfaction are adversely affected when robotic videoconferencing (telerounding) is used in the postoperative setting.

Design  Randomized controlled trial.

Setting  Three academic institutions.

Patients  A total of 270 adults undergoing a urologic procedure requiring a hospital stay of 24 to 72 hours were randomized to receive either traditional bedside rounds or robotic telerounds.

Main Outcome Measures  The primary outcome measure was postoperative patient morbidity. Secondary outcomes were patient-reported satisfaction and hospital length of stay. Other variables assessed included demographics, procedure, operative time, estimated blood loss, and mortality. Patients also completed a validated satisfaction instrument 2 weeks after hospital discharge.

Results  Patients were equally distributed based on the baseline demographic and operative measures. Morbidity rates were similar between the study arms (standard rounds vs telerounds: 16% vs 13%; P = .64). Length of stay was similar in both arms (standard rounds vs telerounds: 2.8 vs 2.8 days; P = .94). In addition, patient satisfaction was equivalently high in both arms of the study.

Conclusions  Robotic telerounds matched the performance of standard bedside rounds after urologic surgical procedures. Virtual visits did not result in missed or increased postoperative complications. Hospital length of stay and ratings of hospital satisfaction were on par with those for traditional rounding.

Author Affiliations: Departments of Urology, University of California, Davis, Sacramento (Drs Ellison and Nguyen), and Sentara Health, Norfolk, Virginia (Drs Fabrizio and Soh); and James Buchanan Brady Urological Institute, Johns Hopkins Medical Institutions, Baltimore, Maryland (Drs Permpongkosol and Kavoussi). Dr Ellison is now with the Department of Urology, Penobscot Bay Medical Center, Rockport, Maine.

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Arch Surg. 2007;142(12):1181.
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