TTP3.02 A three-cycle audit reviewing compliance with Enhanced Recovery after Surgery (ERAS) protocol following colorectal resections

Aim This 3-cycle audit looks at our local compliance with the ERAS protocol to improve patient outcomes. Methods Mixed method study. Per cycle, this prospective project of 10 consecutive patients undergoing elective colorectal resections identified quantitative data for assessment of compliance levels (30 total). Qualitative response to changes were sought from the wider MDT to assess the response to the booklet and suggestions for improvements. Data collection took place over a 2-year period. Interventions included staff education and a comprehensive post-operative ERAS booklet for completion during the inpatient stay. Results Key areas of success:Average length of stay between cycles 2 and 3 reduced from 9 to 6Compliance improvements in oral nutritional supplementation, promotion of deep breathing exercises, oral fluid intake and completion of stoma care plans; all now average >90% compliance.More clear documentation regarding time out of bed and mobilisation on/off the ward. Key areas of concern:Poor documentation of discharge planning – less than 50% had this documentedMany patients are declining nutritional supplementationQuantification of mobilisation remains low (<50%) Conclusions Overall, the introduction of an ERAS protocol booklet to inpatient care has shown significant improvements in compliance with numerous aspects of the ERAS protocol. This project demonstrated the importance of multi-disciplinary team working to ensure the best outcomes. This project in on going and hopes to incorporate pre- and peri-operative aspects of ERAS soon. This local audit may demonstrate strategies that are transferrable to other centres.