Document Detail


Enhanced recovery protocol: implementation at a county institution with limited resources.
MedLine Citation:
PMID:  23025936     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
The benefits of an enhanced recovery protocol (ERP) in colorectal surgery have been well described; however, data on the implementation process is minimal, especially in a resource-limited institution. The purpose of this study was to evaluate outcomes during implementation of a physician-driven ERP at a public-funded institution. We retrospectively reviewed all elective colorectal surgery during a transition from standard care to an ERP (implemented via a standard order sheet). Data regarding use of care plan, length of stay (LOS), and rates of postoperative complications and readmission were recorded. One hundred eleven patients were included in the study; however, complete use of the ERP after its introduction occurred in a total of 50 patients for a compliance rate of 60 per cent (95% confidence interval [CI], 49 to 70). Late implementation of ERP diet, analgesics, and activity were the most common process errors. Full application of the ERP reduced mean LOS by 3 days (P = 0.002), and there was a trend toward decreased postoperative morbidity without an increase in readmission rate (P = 0.61). Full implementation of an ERP for colorectal surgery faces many challenges in a resource-limited county institution; however, when fully applied, the ERP safely reduced overall LOS, which is important in cost containment.
Authors:
Kais Rona; J Choi; G Sigle; S Kidd; G Ault; A J Senagore
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The American surgeon     Volume:  78     ISSN:  1555-9823     ISO Abbreviation:  Am Surg     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-10-02     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370522     Medline TA:  Am Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1041-4     Citation Subset:  IM    
Affiliation:
Division of Colorectal Surgery, Department of Surgery, Keck School of Medicine at the University of Southern California, Los Angeles, California, USA.
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