To shorten hospital stays and save money, train patients before surgery

Researchers with Michigan Medicine in Ann Arbor have developed a pre-surgical training program for patients, which can concurrently reduce the length of hospital stays and costs associated with inpatient admission.

The third study assessing the program — dubbed the Michigan Surgical Home and Optimization Program — was published in the journal Surgery in February. For the study, researchers asked patients walk every day and self-monitor physical activity. Most patients were asked to log 12 miles of walking per week. They were given pedometers to monitor the distance they traveled.

A total of 641 patients who underwent major elective general and thoracic surgery between June 2014 and December 2015 enrolled in the study. Approximately 82 percent reported active engagement in the program. An analysis of care outcomes found active participation in MSHOP to be associated with a 31 percent reduction in the duration of hospital stay and a 28 percent overall reduction in costs.

"We do a lot in medicine to get people ready for surgery, but they're primarily administrative tasks — checking off boxes that don't necessarily make a patient better," said Michael Englesbe, MD, transplant surgeon with Michigan Medicine who has studied and championed the philosophy behind the MSHOP program for close to 10 years. "The more you can do to manage your status preoperatively, the quicker you'll be able to bounce back."

Since the program was established five years ago, it has been implemented at more than 20 hospitals and 30 practices across Michigan.

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