JPRAS open · 2026
Patient experience after shared medical appointments and in-office WALANT carpal tunnel release: a prospective evaluation of satisfaction, cost and waste reduction.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
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История · было → стало
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Hedspång Mattias, Briland Simon, Sagerfors Marcus, Reiser Daniel
Аннотация
PURPOSE: To evaluate patient experience after a revised pathway combining same-day shared medical appointments with in-office wide-awake local anesthesia with no tourniquet (WALANT) carpal tunnel release, and to assess efficiency, waste generation, and costs.
METHODS: This prospective observational pilot study included patients undergoing carpal tunnel release using a revised pathway at a Swedish hand surgery department. Approximately six patients per half-day session attended a structured preoperative shared group information session before surgery, with an opportunity for individual questions before local anesthesia. Procedures were performed in two consultation rooms using WALANT, field sterility, limited draping, absorbable sutures, and simplified follow-up. No anesthesiologist or anesthesia personnel were involved. Patient experience was assessed with the Picker Patient Experience-15 (PPE-15) questionnaire and postoperative questions. Waste was weighed and a cost-reduction analysis was performed.
RESULTS: Sixty patients (mean age 55 years, 70% women) underwent 62 carpal tunnel releases. The mean PPE-15 score was 97.8, and 57 of 60 respondents reported no pain. Of the 17 patients with previous contralateral standard carpal tunnel release, 16 rated the revised pathway as better and one as equal. Five patients met the criteria for physician wound assessment; none had infection. Waste was reduced from 2.20 kg to 0.55 kg per procedure. The estimated saving was 225 Euro per procedure at the clinic level and 289 Euro at the regional level when reduced follow-up was included.
CONCLUSION: Same-day shared medical appointments combined with in-office WALANT carpal tunnel release were associated with high patient satisfaction, low reported pain, reduced waste, improved efficiency, and lower estimated costs. Larger comparative studies are needed to confirm the safety and evaluate the independent effect of group information.
METHODS: This prospective observational pilot study included patients undergoing carpal tunnel release using a revised pathway at a Swedish hand surgery department. Approximately six patients per half-day session attended a structured preoperative shared group information session before surgery, with an opportunity for individual questions before local anesthesia. Procedures were performed in two consultation rooms using WALANT, field sterility, limited draping, absorbable sutures, and simplified follow-up. No anesthesiologist or anesthesia personnel were involved. Patient experience was assessed with the Picker Patient Experience-15 (PPE-15) questionnaire and postoperative questions. Waste was weighed and a cost-reduction analysis was performed.
RESULTS: Sixty patients (mean age 55 years, 70% women) underwent 62 carpal tunnel releases. The mean PPE-15 score was 97.8, and 57 of 60 respondents reported no pain. Of the 17 patients with previous contralateral standard carpal tunnel release, 16 rated the revised pathway as better and one as equal. Five patients met the criteria for physician wound assessment; none had infection. Waste was reduced from 2.20 kg to 0.55 kg per procedure. The estimated saving was 225 Euro per procedure at the clinic level and 289 Euro at the regional level when reduced follow-up was included.
CONCLUSION: Same-day shared medical appointments combined with in-office WALANT carpal tunnel release were associated with high patient satisfaction, low reported pain, reduced waste, improved efficiency, and lower estimated costs. Larger comparative studies are needed to confirm the safety and evaluate the independent effect of group information.