A Randomized Controlled Trial of Perioperative Education via e-health Technology to Ensure High Quality Equitable Care: One-4-ALL Initiative

Abstract

Background

Our current system of perioperative education offers variable amounts of information to families, contributing to inequitable care. We hypothesized implementing web-based perioperative education for gastrostomy tube (GT) surgery would be feasible without causing patient harm.

Methods

We conducted a randomized controlled trial comparing e-health education to standard education for families of children undergoing GT placement at our center between 6/2023–4/2024. Patients randomized to e-health were assigned preparatory pathways at three times: prior to surgery, prior to hospital discharge, and prior to outpatient follow up. The standard education group received standard perioperative education prior to hospital discharge and at clinic follow up. All participants were asked to complete study surveys at the three timepoints. Clinical outcomes data were collected to assess potential patient harm.

Results

We enrolled 62 families: 30 randomized to e-health and 32 to standard education. Demographic factors were similar between groups. Eighty-seven percent of e-health families created an account and viewed the web-based content. Both groups reported high readiness for surgery with 89 % or more reporting GT surgery will benefit my child's health and they were comfortable deciding to elect for GT surgery. The rate of common clinical complications did not differ between groups.

Conclusions

An e-health platform to provide perioperative education to families of patients undergoing GT surgery is feasible without negatively impacting patient outcomes. This approach has the potential to improve on our current standard by offering education in a family's preferred language, their own pace, and their own schedule.

Level of evidence

Level II – randomized controlled trial.