Migration of an established pre-operative education session for robot-assisted radical prostatectomy patients to telehealth: A quality improvement initiative

Pre-operative patient education for robotic radical prostatectomy is a standard of care in many specialized centres that improves patient satisfaction and outcomes. We previously reported outcomes of our institution's Robotic Prostatectomy Care Pathway (Robocare). As a quality improvement initiative, we migrated Robocare to a telehealth platform (Tele-Robocare) and report our initial experience and outcomes. Between February 2020 and July 2021, all patients waitlisted for robot-assisted radical prostatectomy (RARP) were recruited. Patients with cognitive impairments, medical or mental health disorders that may preclude proper engagement in a group or online setting were excluded. Informed consent was sought for Tele-Robocare. Dedicated content was created specifically for delivery on digital platform. Patient handouts for pre-reading prior to Tele-Robocare were provided to facilitate consolidation of information. Post-session evaluation form was provided to assess patient receptivity and satisfaction. Qualitative feedback was captured and analysed according to distinct domains of session format, content, delivery and technical support. Between February 2020 and July 2021, 171 patients planned for robotic radical prostatectomy (RARP) were enrolled for Tele-Robocare. A total of 147 (86%) patients successfully attended the session. Of those recruited but did not attend, 8 were patient-initiated cancellations, 7 had other conflicting appointments, 2 had technical issues, 2 did not have enough time before surgery and 1 refused participation. Of the attendees, 135 (92%) completed evaluation. 134 (99%) patients expressed that Tele-Robocare was useful and 135 (100%) found that Tele-Robocare was adequate in addressing the pre-operative concerns and information gaps. We received 126 qualitative feedbacks distilled to 211 separate items. Content was the most liked feature (98, 46%), followed by the presenter (37, 18%) and session delivery (28, 13%). Areas of improvement identified included technical support (10, 5%), session format (5, 3%) and session length (5, 3%). Analysing other benefits of a virtual engagement, the total driving distance saved by these patients who would have to otherwise attend a physical session was 57 072 kilometres and total travel time saved was 43 956 min. Tele-Robocare is a novel patient education program. It is successful in providing virtual pre-operative education service with high patient acceptance, satisfaction and potential impact on climate change. Continued feedback from patients will help enhance the program to meet more patient needs in the future. This quality improvement initiative was reviewed and accepted by the Peter MacCallum Cancer Centre – Ethics Department, Melbourne, Australia.