Presentation Authors: Tung-Chin Hsieh*, San Diego, CA, Martin Gross, Hanover, NH, Ashley Tapscott, Huntersville, NC, Ranjith Ramasamy, Miami, FL, Ashely Bowen, Oklahoma City, OK, Sheldon Freedman, Las Vegas, NV, Michael Wierschem, Plano, TX, Charles Welliver, Albany, NY, Frank Simoncini, Mesa, AZ, Alberto Duboy, Tampa, FL, Raul Clavijo, Davis, CA, Jay Simhan, Philadelphia, PA, Arnold Bullock, St Louis , MO, Paul Perito, Miami, FL
Introduction: Penile prosthetic surgery (PS) is an effective treatment option for men with erectile dysfunction. Cancellation of surgery is disruptive and costly to patients, physicians and the healthcare system. We sought to analyze PS cancellation patterns and improve PS cancellation rates by utilizing a video-based technology in a novel quality improvement project
Methods: We sampled industry-reported data to determine baseline PS completion, rescheduling and cancellation rates. Patient and physician practice factors affecting cancellation and rescheduling were also established. Selected surgeons then implemented Vidscrip, a video-based patient education program. Prerecorded videos with patient instructions were delivered via text message at 14 days, 7 days, 1 day preoperatively and 1 day postoperatively. Postprogram implementation assessments were also performed. Standard statistical analysis was applied with p-values < 0.05 considered significant.
Results: From January 2018 to September 2018, 226 total PS were scheduled in selected territories within California and Colorado. Of these, 62.5% were completed, and 37.5% were either rescheduled or cancelled. The most common patient and/or physician etiologies for surgical rescheduling or cancellation included: incomplete medical clearance (50%), scheduling issues (18%), and patient changed their decision to proceed with surgery (11%). A video-based patient education program was subsequently implemented in 182 patients from July 2018 onward. 96 patients reached PS date: 81 completed, 4 rescheduled and 11 cancelled surgery. A reduction of cancellation rate was observed compared to pre-implantation data (11%, p < 0.05). There was also a reduction of incomplete medical clearance as the etiology for rescheduling/cancellation (20%, p < 0.05)
Conclusions: PS is associated with a significant cancellation and rescheduling rate. A video-based patient education program can reduce PS cancellation rate and potentially reduce costs, while improving efficiency and quality of care for men suffering from erectile dysfunction. Wider implementation is needed to validate these findings