Key result
Dedicated operating room teams in a colorectal surgery ERAS pathway were strongly associated with high protocol compliance (p<0.001), reducing length of stay (p<0.01) and morbidity (p<0.009).
Why the study?
Does the establishment of dedicated operating room teams improve process measure compliance and clinical outcomes in patients undergoing colorectal surgery in an ERAS program?
Observational
Does the establishment of dedicated operating room teams improve process measure compliance and clinical outcomes in patients undergoing colorectal surgery in an ERAS program?
Dedicated operating room teams in an ERAS pathway for colorectal surgery increase protocol compliance, which is associated with improved clinical outcomes including reduced length of stay and morbidity.
Answers are grounded in this paper and cite their sources.
Dedicated teams may aid ERAS compliance and outcomes in colorectal surgery; leaves open causal confirmation in randomized trials.
BACKGROUND: Our aim was to determine whether the establishment of a dedicated operating room team leads to improved process measure compliance and clinical outcomes in an Enhanced Recovery after Surgery (ERAS) program. Enhanced Recovery after Surgery programs involve the application of bundled best practices to improve the value of perioperative care. Successful implementation and sustainment of ERAS programs has been linked to compliance with protocol elements. STUDY DESIGN: Development of dedicated teams of anesthesia providers was a component of ERAS implementation. Intraoperative provider team networks (surgeons, anesthesiologists, and certified registered nurse anesthetists) were developed for all cases before and after implementation of colorectal ERAS. Four measures of centrality were analyzed in each network based on case assignments, and these measures were correlated with both rates of process measure compliance and clinical outcomes. RESULTS: Enhanced Recovery after Surgery provider teams led to a decrease in the closeness of anesthesiologists (p = 0.04) and significant increase in the clustering coefficient of certified registered nurse anesthetists (p = 0.005) compared with the pre-ERAS network. There was no significant change in centrality among surgeons (p = NS for all measures). Enhanced Recovery after Surgery designation among anesthesiologists and nurse anesthetists-whereby individual providers received an in-service on protocol elements and received compliance data was strongly associated with high compliance (>0.6 of measures; p < 0.001 for each group). In addition, high compliance was associated with a significant reduction in length of stay (p < 0.01), surgical site infection (p < 0.002), and morbidity (p < 0.009). CONCLUSIONS: Dedicated operating room teams led to increased centrality among anesthesia providers, which in turn not only increased compliance, but also improved several clinical outcomes.
No takes yet. Share an insight, caveat, or question.
Grant et al. (2017) conducted an observational in Colorectal surgery. Dedicated operating room teams (anesthesia providers) vs. Pre-ERAS network (non-dedicated teams) was evaluated on Process measure compliance and clinical outcomes (length of stay, surgical site infection, and morbidity) (p=<0.001). Dedicated operating room teams in a colorectal surgery ERAS pathway were strongly associated with high protocol compliance (p<0.001), reducing length of stay (p<0.01) and morbidity (p<0.009).
Synapse has enriched 10 related papers. Consider them for comparative context: