Why the study?
Although ERAS is considered standard of care, utilization remains low and substantial practice variation exists in elective colorectal surgery.
What are the predictors of Enhanced Recovery After Surgery (ERAS) utilization and practice variations in elective colorectal surgery among general surgeons in Ontario?
Cross-Sectional (n=235)
Yes
What are the predictors of Enhanced Recovery After Surgery (ERAS) utilization and practice variations in elective colorectal surgery among general surgeons in Ontario?
Odds Ratio: 0.86 (95% CI 0.42–1.31)
p-value: p=<0.001
Despite ERAS being considered standard of care, substantial practice variation exists and ERAS behaviors are not widely formalized into hospital protocols among general surgeons in Ontario.
Academic-community ERAS disparities merit targeted quality improvement; leaves open drivers of variation and protocol formalization.
BACKGROUND: Enhanced Recovery After Surgery (ERAS) protocols use evidence-based perioperative practices that reduce morbidity and length of stay and improve patient satisfaction. ERAS is considered standard of care; however, utilization remains low and substantial practice variation exists. The aim of this study was to pragmatically characterize variation in colorectal surgery practice and identify predictors of ERAS utilization. METHODS: A survey of general surgeons identified using the Ontario College of Physicians and Surgeons database was conducted. Information on basic demographic characteristics, utilization of ERAS and predictors of ERAS implementation was collected. Nine ERAS behaviours were analyzed. Multivariable analysis was used to determine effects of demographic, hospital and surgeon covariates on ERAS utilization. RESULTS: = 0.16, respectively). CONCLUSION: Substantial practice variation in colorectal surgery still exists. Individual ERAS principles are commonly followed; however, ERAS behaviours are not widely formalized into hospital protocols.
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Springer et al. (2020) conducted a cross-sectional in Elective colorectal surgery (n=235). Academic hospital setting vs. Small community hospital was evaluated on Number of ERAS behaviors practiced (OR 0.86, 95% CI 0.42 to 1.31, p=<0.001).
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