Implementation of Same-Day Discharge in Minimally Invasive Gynecologic Surgery in a Safety-Net Hospital

The primary objective of this study was to implement a same-day discharge pathway for patients undergoing minimally invasive gynecologic surgery at an urban, safety-net hospital. Prior to implementation, patients routinely spent one to two nights in the hospital postoperatively. This project was implemented on December 3, 2018. We utilized a screening tool to identify eligible patients for same-day discharge. The primary outcome measure was the percentage of patients discharged the same day of the surgery. We compared data between patients discharged home same day versus patients admitted to the hospital, as well as patients who underwent benign minimally invasive gynecologic surgery prior to and after project implementation. Of the 237 patients undergoing minimally invasive gynecologic surgery, 209 were eligible for same-day discharge. More than half (111, 53.1%) of the eligible patients were discharged home on the same day. Same-day discharge was not found to be associated with an increased risk of adverse events compared to patients who were not discharged same day. Same-day discharge after minimally invasive gynecologic surgery is safe and feasible in an urban safety-net hospital, especially with the addition of a screening tool to identify social determinants of health prior to surgery.