Standardization of Care: Impact of an Enhanced Recovery Protocol on Length of Stay, Complications, and Direct Costs after Colorectal Surgery Robert H.

Slides:

Advertisements

Similar presentations

Physician-Owned Surgical Hospitals Outperform Other Hospitals in Medicare Value- Based Purchasing Program Adriana G. Ramirez, MD, Margaret C. Tracci,

Advertisements

Early Wound Morbidity after Open Ventral Hernia Repair with Biosynthetic or Polypropylene Mesh Sambit Sahoo, MD, PhD, Ivy N. Haskins, MD, Li-Ching Huang,

Comparative Efficacy of Bilateral Thoracoscopic Splanchnicectomy for Intractable Pain Secondary to Pancreatic Cancer vs Chronic Pancreatitis Neal Bhutiani,

The Hartford Consensus: Survey of the Public and Healthcare Professionals on Active Shooter Events in Hospitals Lenworth M. Jacobs, MD, MPH, FACS, Karyl.

Association of Safety Culture with Surgical Site Infection Outcomes

Camilo Correa-Gallego, MD, Helen E

Trend in Volume of Urologic Prosthetic Surgery after Initiation of Prostate Cancer Survivorship Program Alison M. Rasper, MD, Kara E. McAbee, MD, Marc.

Biologic vs Synthetic Inguinal Hernia Repair: 1-Year Results of a Randomized Double- Blinded Trial Grant V. Bochicchio, MD, MPH, FACS, Ajay Jain, MD,

Simple Suturing Technique for Umbilical Dimple Wound after Single-Incision Laparoscopic Surgery Yoichi Matsui, MD, PhD, Sohei Satoi, MD, PhD, FACS, Satoshi.

Evolution of Laparoscopic Liver Surgery from Innovation to Implementation to Mastery: Perioperative and Oncologic Outcomes of 2,238 Patients from 4 European.

Exploring the Relationship Between Stereotype Perception and Residents' Well-Being Arghavan Salles, MD, PhD, Claudia M. Mueller, PhD, MD, FACS, Geoffrey.

Michael T. Kassin, MD, Rachel M. Owen, MD, Sebastian D

Mary J. Edwards, MD, FACS, Michael Lustik, MS, Mark W

Preoperative Standard Oral Nutrition Supplements vs Immunonutrition: Results of a Systematic Review and Meta-Analysis Refaat A. Hegazi, MD, PhD, MPH,

Simple Suturing Technique for Umbilical Dimple Wound after Single-Incision Laparoscopic Surgery Yoichi Matsui, MD, PhD, Sohei Satoi, MD, PhD, FACS, Satoshi.

Bouffant vs Skull Cap and Impact on Surgical Site Infection: Does Operating Room Headwear Really Matter? Shanu N. Kothari, MD, FACS, Madeline J. Anderson,

Robert J Cerfolio, MD, Cyndi Bass, MSN, Charles R Katholi, PhD

Introduction of Mechanical Sphincter Augmentation for Gastroesophageal Reflux Disease into Practice: Early Clinical Outcomes and Keys to Successful Adoption

Are Surgeons Being Paid Fairly by Medicaid

Intraoperative Hemoglobin Levels and Transfusion Independently Predict Stroke After Cardiac Operations Zainab S. Bahrainwala, BS, Maura A. Grega, RN,

A Patient-Centered Early Warning System to Prevent Readmission after Colorectal Surgery: A National Consensus Using the Delphi Method Linda T. Li, MD,

Perceived Complexity of Various Liver Resections: Results of a Survey of Experts with Development of a Complexity Score and Classification Major K. Lee,

Nonclinical Factors Associated with 30-Day Mortality after Lung Cancer Resection: An Analysis of 215,000 Patients Using the National Cancer Data Base

Interim Analysis of a Prospective Multi-Institutional Study of Surgery Resident Experience with Flexibility in Surgical Training Darren R. Cullinan,

Creating Individual Surgeon Performance Assessments in a Statewide Hospital Surgical Quality Improvement Collaborative Christopher M. Quinn, MS, Karl.

A Novel Approach to Calculating Small Intestine Length Based on Magnetic Resonance Enterography Nicole A. Wilson, PhD, MD, Hyung-Soon Park, PhD, Kyoung.

Intraoperative Microbreaks Exercises Impact Surgical Trainees’ Musculoskeletal Discomfort and Workload Amro M. Abdelrahman, MB, BS, Bethany R. Lowndes,

Gastric Perforation Associated with Bilateral Inguinal Hernias

How should we treat air leaks?

Laila Hellgren, MD, Elisabeth Ståhle, MD, PhD

Daniel A. Barocas, MD, MPH, FACS, Chirag S. Kulahalli, BS, Jesse M

Maureen V. Hill, MD, Ryland S. Stucke, MD, Sarah E

Implementation of Enhanced Recovery After Surgery in a Community Hospital: An Evidence-Based Approach Michele Persico, MSN, RN-BC, CCRN-CSC, David Miller,

Taking Control of Your Surgery: Impact of a Prehabilitation Program on Major Abdominal Surgery Ryan Howard, MD, Yue S. Yin, BS, Lane McCandless, BS,

T. Ledowski, J. Burke, J. Hruby British Journal of Anaesthesia

Damien J. LaPar, MD, MS, James M. Isbell, MD, MSCI, Daniel P

Complications of Pediatric Cholecystectomy: Impact from Hospital Experience and Use of Cholangiography Lorraine I. Kelley-Quon, MD, MSHS, Adrian Dokey,

Enhancing Patient Outcomes while Containing Costs after Complex Abdominal Operation: A Randomized Controlled Trial of the Whipple Accelerated Recovery.

Nader N. Massarweh, MD, MPH, David R. Flum, MD, MPH, FACS, Rebecca G

Jared P. Beller, MD, Irving L. Kron, MD

Timed Stair Climbing Is the Single Strongest Predictor of Perioperative Complications in Patients Undergoing Abdominal Surgery Sushanth Reddy, MD, FACS,

Outcomes in the Management of Appendicitis and Cholecystitis in the Setting of a New Acute Care Surgery Service Model: Impact on Timing and Cost Robert.

Development Process and Technical Aspects of Laparoscopic Hepatectomy: Learning Curve Based on 15 Years of Experience Shohei Komatsu, MD, PhD, FACS,

Lisa M. Knowlton, MD, MPH, FRCSC, Arden M

Association of Safety Culture with Surgical Site Infection Outcomes

Standardization of Care: Impact of an Enhanced Recovery Protocol on Length of Stay, Complications, and Direct Costs after Colorectal Surgery Robert H.

Trend in Volume of Urologic Prosthetic Surgery after Initiation of Prostate Cancer Survivorship Program Alison M. Rasper, MD, Kara E. McAbee, MD, Marc.

Military surgeons just want to have fun

Simulation in Surgical Education: Influences of and Opportunities for the Southern Surgical Association John B. Hanks, MD, FACS Journal of the American.

Retained Surgical Sponges: Findings from Incident Reports and a Cost-Benefit Analysis of Radiofrequency Technology Tamara L. Williams, MSN, Derrick K.

Assessing Learning During Morbidity and Mortality Conference with a Real-time Response System Ira L. Leeds, MD, Sandra DiBrito, MD, Christian Jones,

Exploring the Relationship Between Stereotype Perception and Residents' Well-Being Arghavan Salles, MD, PhD, Claudia M. Mueller, PhD, MD, FACS, Geoffrey.

Fifteen-Year Trauma System Performance Analysis Demonstrates Optimal Coverage for Most Severely Injured Patients and Identifies a Vulnerable Population

Significant Variation in Surgical Supply Cost Secondary to Surgeon Preference for Laparoscopic Cholecystectomy Michelle C. Nguyen, MD, Matthew J. Luzum,

Timing of Complications and Length of Stay after Rectal Cancer Surgery

Rebecca L. Hoffman, MD, Rachel R. Kelz, MD, FACS, Christopher J

David J. Hall, MD, Kevin R. Olsen, MD, Juan C. Mira, MD, Patrick W

Angela M. Ingraham, MD, Mark E. Cohen, PhD, Mehul V

Robert James Cerfolio, MD, FACS, FCCP, Ayesha S. Bryant, MSPH, MD

Excision with Split-Thickness Skin Graft and Negative-Pressure Therapy for the Treatment of Hidradenitis: A Potential Cure? Robert T. Nevitt, MD, Lauren.

Research incentive program for clinical surgical faculty associated with increases in research productivity Anneke T. Schroen, MD, MPH, FACS, Monika.

Joel T. Adler, MD, MPH, Heidi Yeh, MD, James F

Relevance of the Surgical Care Improvement Project on glycemic control in patients undergoing cardiac surgery who receive continuous insulin infusions

Superiority of moderate control of hyperglycemia to tight control in patients undergoing coronary artery bypass grafting Castigliano M. Bhamidipati,

Implementation of an Interactive Virtual-World Simulation for Structured Surgeon Assessment of Clinical Scenarios Vishal Patel, MRCS, Rajesh Aggarwal,

Journal of the American College of Surgeons

Blake Cady, MD, Thomas Miner, MD, Abraham Morgentaler, MD

Trauma: Still the Cornerstone of Acute Care Surgery Specialty

Impact of Resident Involvement in Surgery (IRIS-NSQIP): Looking at the Bigger Picture Based on the American College of Surgeons-NSQIP Database Antoine.

Ruchi Thanawala, MD, Jonathan L. Jesneck, PhD, Gladys L

Presentation transcript:

Standardization of Care: Impact of an Enhanced Recovery Protocol on Length of Stay, Complications, and Direct Costs after Colorectal Surgery Robert H. Thiele, MD, Kathleen M. Rea, MSN, APRN, Florence E. Turrentine, PhD, RN, Charles M. Friel, MD, FACS, Taryn E. Hassinger, MD, Bernadette J. Goudreau, BS, Bindu A. Umapathi, MD, Irving L. Kron, MD, FACS, Robert G. Sawyer, MD, FACS, Traci L. Hedrick, MD, FACS, Timothy L. McMurry, PhD Journal of the American College of Surgeons Volume 220, Issue 4, Pages 430-443 (April 2015) DOI: 10.1016/j.jamcollsurg.2014.12.042 Copyright © 2015 American College of Surgeons Terms and Conditions

Figure 1 Intraoperative fluid management algorithm. EBL, estimated blood loss; gtt, drip; MAP, mean arterial pressure; PHE, phenylephrine; PVI, Pleth Variability Index; UOP, urine output. Journal of the American College of Surgeons 2015 220, 430-443DOI: (10.1016/j.jamcollsurg.2014.12.042) Copyright © 2015 American College of Surgeons Terms and Conditions

Figure 2 Numeric pain scores for patients undergoing open colorectal surgery on day of surgery (DOS) and postoperative days (POD) 1 to 3. ERAS, enhanced recovery after surgery. Journal of the American College of Surgeons 2015 220, 430-443DOI: (10.1016/j.jamcollsurg.2014.12.042) Copyright © 2015 American College of Surgeons Terms and Conditions

Figure 3 Numeric pain scores for patients undergoing laparoscopic colorectal surgery on day of surgery (DOS) and postoperative days (POD) 1 to 3. ERAS, enhanced recovery after surgery. Journal of the American College of Surgeons 2015 220, 430-443DOI: (10.1016/j.jamcollsurg.2014.12.042) Copyright © 2015 American College of Surgeons Terms and Conditions

Figure 4 Histogram of adjusted length of stay (LOS) demonstrating a shift of the curve to the left during the enhanced recovery protocol with fewer outliers. Dark blue bar, pre–enhanced recovery after surgery (ERAS); light blue bar, post-ERAS. Journal of the American College of Surgeons 2015 220, 430-443DOI: (10.1016/j.jamcollsurg.2014.12.042) Copyright © 2015 American College of Surgeons Terms and Conditions

Figure 5 Length of stay (LOS) for colorectal surgery patients relative to the medical center as a whole. ERAS, enhanced recovery after surgery. Journal of the American College of Surgeons 2015 220, 430-443DOI: (10.1016/j.jamcollsurg.2014.12.042) Copyright © 2015 American College of Surgeons Terms and Conditions