Addressing Perioperative Needs in Head and Neck Cancer: Piloting a Nurse Practitioner-Led Preoperative Virtual Visit.
Gao RW, Adil A, Vance K, Leginza M, Spector ME, Casper KA
Abstract
Objective To improve understanding of the postoperative care challenges of patients with head and neck cancer and to help address these care needs before surgery. Study design Qualitative study with intervention development and process testing. Setting Tertiary care academic medical center. Methods To examine perioperative patient experiences, we first performed interviews of 28 adult patients with head and neck cancer undergoing resection with microvascular free flap reconstruction. We then developed a unique preoperative virtual visit focused on socioeconomic and perioperative needs. 50 visits were then conducted by advanced practice providers, and visit content was analyzed. Results Before the new preoperative visit, 73% of patients did not plan for postoperative care preoperatively and 73% did not feel comfortable with postoperative care needs. 55% reported unaddressed socioeconomic hardship. Themes included: limited understanding of surgery and limited understanding of postoperative care needs. After the new preoperative visit, 62% of visits addressed significant care-related concerns not previously identified. Conclusion An additional preoperative virtual visit by an advanced practice provider may help improve surgical expectations and better prepare patients and their caregivers for perioperative needs.