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

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

1 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 (April 2015) DOI: /j.jamcollsurg Copyright © 2015 American College of Surgeons Terms and Conditions

2 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  , DOI: ( /j.jamcollsurg ) Copyright © 2015 American College of Surgeons Terms and Conditions

3 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  , DOI: ( /j.jamcollsurg ) Copyright © 2015 American College of Surgeons Terms and Conditions

4 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  , DOI: ( /j.jamcollsurg ) Copyright © 2015 American College of Surgeons Terms and Conditions

5 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  , DOI: ( /j.jamcollsurg ) Copyright © 2015 American College of Surgeons Terms and Conditions

6 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  , DOI: ( /j.jamcollsurg ) Copyright © 2015 American College of Surgeons Terms and Conditions

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