A randomized controlled trial of a distress screening, consultation, and targeted referral system for family caregivers in oncologic care.

Objective: Distress screening is standard practice among oncology patients, yet few routine distress screening programs exist for cancer caregivers. The objective of this study was to demonstrate the feasibility, acceptability, and preliminary efficacy of Cancer Support Source-Caregiver (CSS-CG, 33-item), an electronic distress screening and automated referral program with a consultation (S + C) to improve caregiver unmet needs, quality of life, anxiety, depression, and distress relative to Enhanced Usual Care (EUC; access to educational materials).

Method: 150 caregivers of patients with varying sites/stages of cancer were randomized to S + C or EUC and completed assessments at baseline, 3-months post-baseline, and 6-months post-baseline.

Reducing opioid prescribing after ambulatory breast reconstruction surgery.

Background: The lack of evidence-based guidelines for postoperative opioid prescriptions following breast reconstruction contributes to a wide variation in prescribing practices and increases potential for misuse and abuse.

Methods: Between August and December 2019, women who underwent outpatient breast reconstruction were surveyed 7-10 days before (n = 97) and after (n = 101) implementing a standardized opioid prescription reduction initiative. We compared postoperative opioid use, pain control, and refills in both groups.

Effect of a Predictive Model on Planned Surgical Duration Accuracy, Patient Wait Time, and Use of Presurgical Resources: A Randomized Clinical Trial.

Importance: Accurate surgical scheduling affects patients, clinical staff, and use of physical resources. Although numerous retrospective analyses have suggested a potential for improvement, the real-world outcome of implementing a machine learning model to predict surgical case duration appears not to have been studied.

Objectives: To assess accuracy and real-world outcome from implementation of a machine learning model that predicts surgical case duration.

Standardizing Opioid Prescriptions to Patients After Ambulatory Oncologic Surgery Reduces Overprescription.

Background: Overprescribing of opioids after surgery contributes to long-term abuse. Evaluating opioid prescription patterns and patient-reported opioid use offers an evidence-based method to identify potential overprescription. This quality improvement initiative aimed to reduce and standardize opioid prescriptions upon discharge from an ambulatory oncologic surgery center and evaluate the effect of this change on patients' subsequent opioid use and reported pain.

Complex Cancer Surgery in the Outpatient Setting: The Josie Robertson Surgery Center.

Minimally invasive operative techniques and enhanced recovery after surgery (ERAS) protocols have transformed clinical practice and made it possible to perform increasingly complex oncologic procedures in the ambulatory setting, with recovery at home after a single overnight stay. Capitalizing on these changes, Memorial Sloan Kettering Cancer Center's Josie Robertson Surgery Center (JRSC), a freestanding ambulatory surgery facility, was established to provide both outpatient procedures and several surgeries that had previously been performed in the inpatient setting, newly transitioned to this ambulatory extended recovery (AXR) model. However, the JRSC core mission goes beyond rapid recovery, aiming to be an innovation center with a focus on superlative patient experience and engagement, efficiency, and data-driven continuous improvement.

Impact of caregiver overnight stay on postoperative outcomes.

Purpose: The purpose of this paper is to determine the impact of having a patient-designated caregiver remain overnight with ambulatory extended recovery patients on early postoperative clinical outcomes.

Design/methodology/approach: This was a retrospective cohort study of patients undergoing surgery requiring overnight stay in a highly resourced free-standing oncology ambulatory surgery center. Postoperative outcomes in patients who had caregivers stay with them overnight were compared with outcomes in those who did not.

Preoperative Anxiety in Patients Undergoing Outpatient Cancer Surgery.

Objective: Our primary research aim was to determine the prevalence of preoperative anxiety in patients undergoing outpatient cancer surgery. Our secondary aim was to examine the association between preoperative anxiety and negative intraoperative and postoperative outcomes in patients undergoing outpatient cancer surgery, including increased anesthesia requirements, postoperative nausea and vomiting (PONV), extended overnight stay, total length of stay (LOS), transfer to hospital, surgical complications, and postoperative visits to urgent care centers (UCC).

Methods: We conducted a retrospective cohort study to investigate the prevalence of preoperative anxiety and its association with postoperative outcomes in patients undergoing outpatient cancer surgery.

Feasibility and Acceptability of Distress Screening for Family Caregivers at a Cancer Surgery Center.

Objectives: To determine the feasibility and acceptability of a validated electronic distress screening program for cancer caregivers.

Sample & Setting: 17 informal caregivers presenting with a patient with cancer to an ambulatory cancer surgery center.

Methods & Variables: Caregivers completed the CancerSupportSource®-Caregiver screening and a brief semistructured interview concerning the screening.