Institutional factors associated with adherence to enhanced recovery protocols for colorectal surgery: Secondary analysis of a multicenter study

Autor: Andres Zorrilla-Vaca, Alexander B. Stone, Javier Ripolles-Melchor, Ane Abad-Motos, Jose M. Ramirez-Rodriguez, Patricia Galan-Menendez, Gabriel E. Mena, Michael C. Grant, Cristina Garcia-Perez, Eva Higuera-Míguelez, José M. Marcos-Vidal, María Merino-García, Ana B. Rubio-López, María E. Pascual-Diez, Francisco J. García-Miguel, Luis R. Cabezudo-Sanjose, Ruth Martínez-Díaz, Sara Alegría-Rebollo, José L. González-Rodríguez, María S. Vega-Cruz, Gema Martínez-Ragüés, Manuel A. Gómez-Ríos, Eva Mosquera-Rodríguez, Sara Del-Río-Regueira, Domingo Bustos-García, María P. Sánchez-Conde, Antonio Rodríguez-Calvo, María A. Hernández-Valero, María Angoso-Clavijo, Luis M. González-Fernández, Miguel A. Bravo-Riaño, María V. Arnes-Muñoz, José R. Perez-Valdivieso, Marta Martin-Vizcaino, Susana Hernandez-Garcia, Francisco J. Yoldi-Murillo, Miguel Salvador-Bravo, Manuela Rubial-Alvarez, Fabiola Oteiza-Martinez, Enrique Balen-Rivera, José A. Garcia-Erce, Ana Zugasti-Murillo, María E. Petrina-Jáuregui, Filadelfo Bustos-Molina, Daniel Paz-Martín, Bárbara Vázquez-Vicente, Lourdes González-López, Conrado Mínguez-Marín, Susana Diz-Jueguen, Jaime Seoane-Antelo, Julio Ballinas-Miranda, Ester Carrera-Dacosta, Erica Barreiro-Domínguez, Alexandra Piñeiro-Teijeiro, Raquel Sanchez-Santos, Marina Varela-Duran, Pilar Diaz-Parada, Aránzazu Calero-Lillo, Manuel Ángel López-Lara, Salvador Muñoz-Collado, Juan Valverde-Sintas, Silvia Aznar-Puig, Daniel Troyano-Escribano, Sandra Marmaña-Mezquita, Jesús Fernanz-Antón, Lucia Catot-Alemany, Jaume Balust, Marta Ubré, Carlos Ferrando-Ortolá, Graciela Martínez-Pallí, Ainitze Ibarzabal, Antonio M. Lacy, Rubén Sánchez-Martín, Karina Martins-Cruz, Paula Pérez-Jiménez, Rubén Casans-Francés, Javier Longás, José M. Ramírez Rodríguez, Ana Mugarra-Llopis, Cristina Crisan, Estefanía Gracia-Ferrándiz, Esther Romero-Vargas, Marina Soro-Domingo, Rita Rodríguez-Jiménez, Blanca Prada-Martin, Henar Muñoz-Hernández, José I. Gómez Herrera, Sara Cocho-Crespo, Sandra Fernández-Caballero, Miguel Flores-Crespo, Andrea Vázquez-Fernández, Carlo Brugiotti, Estefanía Ollé-Sese, Carla R. Houghton-Acuña, Marta López-Doucil, Ernesto A. Tarazona-López, Iván BEL-Marcobal, Sonia González-Cogollor, Manuel Llácer-Pérez, Alberto Arias-Romano, María C. Arrabal-Taborda, Mercedes Caballero-Domínguez, Rafael García-López, Julio Ontoria-Muriel, Antonio Vivó-Blasco, Francisco J. Blanco, Enrique DEL-Cojo-Peces, Jose M. Tena-Guerrero, Aitor Landaluce-Olavarria, Izaskun Badiola, Marta Calvo, Unai DE-Andres, Vicente Portugal-Porras, Bakarne Ugarte-Sierra, Ana Pedregosa-Sanz, Laura Perelló-Cerdà, Yobanys Rodríguez-Téllez, Joanna Grössl-Meleán, Xavier Viñas-Truñén, Enrique Alday-Muñoz, Elena Bermejo-Marcos, Pedro A. Alonso-Casado, Francisco A. Gimeno-Calvo, Ana Rodriguez-Sánchez, Carmen Montes-López, Laura Álvarez-Llano, María J. FAS-Vicent, Juan M. Ortega-Monzó, Gustavo Flores-Flores, José L. Tristancho, Montserrat Bayo-Sans, María C. Deiros-Garcia, María L. GIL-Gómez, Lourdes Parra, Vanesa Tejedor-DE-LA-Fuente, Carlos Jericó-Alba, Núria Borrell-Brau, David Camacho-Martín, Jose L. Ortiz-DE-Zarate, Daniel López-Ruiz, Vicens Rodriguez-Bustamante, M. Martinez-Vilalta, Daniel Amoros-Ruiz, Marc Sadurni-Sarda, Fernando A.L.C.A.L.D.E. Matas, Hernán Giordano, Jose M. Perez Peña, Luis Olmedilla-Arnal, Pilar Benito-SAZ, Elena López-GIL, Adela Ruiz-Ortega, Sara Zapatero-García, Emilio DEL-Valle-García, Víctor Soria-Aledo, Carmen V. Pérez-Guarinos, Enrique Pellicer-Franco, Graciela Valero-Navarro, Mónica Mengual-Ballester, José Andrés García-Marín, Manuel Romero-Simó, Ibán Caravaca-García, Teresa Blasco-Segura, Carlos F. Campo-Betancourth, Rafael David Costa-Navarro, Laura Jordá-Sanz, María I. DE-Miguel-Cabrera, José M. España-Pamplona, Silvia GIL-Trujillo, Francisco J. Redondo-Calvo, Víctor Baladrón-Gónzalez, Remedios Moreno-Ballesteros, José L. Muñoz-Rodes, Elena Miranda, Marta Roselló-Chornet, Lourdes Alós-Zaragoza, Juan Catalá-Bauset, María A. Pallardo-López, Noemí Almenara-Almenara, Lorena Muñoz-Devesa, Benito Alcaide-Pardo, Pablo Gimeno-Fernández, José L. Gómez-Agraz, Carla Iglesias-Morales, Paola B. Ordoñez-Enireb, Ana M. Ríos-Villalba, Joselvy Rodríguez-Pinto, Sergio Sánchez-Cortés, María J. Montoya-Tabares, Vicente Ruiz, Francisco González-Sánchez, Víctor Soriano-Giménez, José M. Muñoz-Camarena, Jorge Benavides-Buleje, Juan C. Estupiñán-Jiménez, Irene Portero-Larragueta, David Alias, María J. Alberola-Estellés, Óscar Díaz-Cambronero, María S. Matoses-Jaén, María D. Ruiz-Boluda, Carlos Maristany-Bienert, José A. Pardo-López, Álvaro Ramiro-Ruiz, Pablo García, Arantza Martínez-DE-Guereñu, Belinda Montalbán, Claudia Olea, David Benguría, Javier Silva, Adriana Calderón, Jordi Escoll-Rufino, Carlos Cerdan-Santacruz, José E. Sierra-Grañón, María Rufas-Acín, Nuria Mestres-Petit, Ingrid C. Penagos-Saavedra, Cristina Moreno-Castilla, Jordi Riera-RIU, Ana Cuellar-Martínez, R.C. González-Álvarez, Míriam Sánchez-Merchante, Santiago García-DEL-Valle-Y-Manzano, Sara García-Zamorano, Natalia Gijón-Herreros, Patricia Robles-Ángel, Margarita Logroño-Ejea, Rodrigo Sanllorente-Sebastian, Maria C. Villalain-Perez, Mihaela Siclama-Stroe, Judith Benítez-Villar, Alberto Sánchez-Campos, Alberto Martínez-Ruiz, Patricia Alonso-Carnicero, Francisco J. DE-LA-Torre-González, Carolina Naranjo-Checa, Fernando Pereira-Pérez, Elena Ruiz-Ucar, Alfredo Rivera, Cristina GIL-Lapetra, Enrique Roca-Castillo, María L. Mariscal-Flores, Mario Morales-Cayuela, Irene Alonso-Ramos, Virginia Jiménez-Carneros, Lucas Casalduero-Garcia, Javier Jimenez-Miramón, L. José, Eva M. Nogués-Ramia, Yolanda Sosa-Quesada, Alonso Gómez, Laura M. Martínez-Meco-Ortiz, Mercedes Cabellos-Olivares, José R. Rodríguez-Fraile, María Labalde-Martínez, null Ramos-Rodríguez, Beatriz Nacarino-Alcorta, Raquel Fernández-García, Borja DE-LA-Quintana-Gordon, Justyna Drewniak, Fátima Senra-L, Pablo Galindo-Jara, Ana B. Gallardo-Herrera, Cesar García-Llorente, Laura Colao-García, Luz-Divina Rellan-Álvarez, Miguel Miro-Murillo, Sahely-CLARET Flores-Risco, Jordi Serrat-Puyol, Adrian Medina-Gallardo, Yuhami Mitsahid-Curbelo-Peña, null Orenzana, Alfredo Abad-Gurumeta, Norma Aracil-Escoda, Eugenio Martínez-Hurtado, Beatriz Nozal-Mateo, Elena Sáez-Ruiz, Rut Salvachua-Fernández, Javier Ripollés-Melchor, María L. DE-Fuenmayor-Valera, Elena Sánchez, Begoña Toribio, Antonio Navarro-Sánchez, José López-Fernández, Dácil Montesdeoca-Cabrera, Francisco J. Alcalá-Serrano, Azahara Sancho-DE-Avila, Sofia Diaz-Carrasco, Almudena Martín-Martín, Alejandro Suarez-DE-LA-Rica, Rafael UÑA-Orejón, Emilio Maseda, Guillermo Tejón-Pérez, María V. Alfaro-Martínez, Marta Alonso-Fernández, María A. Álvarez-Cebrián, María J. Álvarez-DEL-Vayo-Rodríguez, Mariana Carrillo-Rivas, María Fernández-Rodríguez, Sonia Trabanco-Morán, José L. Rábago-Morán, Javier Martínez-Ubieto, Ana M. Pascual-Bellosta, Sonia M. Ortega-Lucea, Maria P. Santero-Ramirez, Maria V. Duque-Mallen, Cristian Aragon-Benedi, Andrea Vallejo-Tarrat, Carmen Colillas-Calvet, Maria J. Laso, Javier Martinez-Cabañero, Javier Hernández-Salván, Beatriz Ledesma-Muñoz, Carolina Ochoa-Osorio, Máximo Sanz-García, Begoña Herrero-Garrote, Alma Blázquez-Martin, Manuel Díez-Alonso, Pilar Hernández-Juara, José M. Muguerza-Huguet, Macarena Barbero-Mielgo, Belén SAN-Antonio-SAN-Román, Laura Alonso-Aguilar, Viktoria Molnar, María C. Delgado-Naviero, Encarnación Meléndez-Leal, Virginia Cavero-García, África Fernández-Sánchez, Daniela A. Cubek-Quevedo, Rocío D.Í.E.Z. Munar, Francisco J. Blázquez-Fernández-DE-LA Pradilla, Ana B. Serrano, Alberto Balvís, Alberto Berruezo, Elena Esparza, Inés D.E.L.A. HOZ, Ana Palavicini, Lucia Pereira, Ximena Vega, Judith Villahoz, Gema Villanueva, José I. Alonso-Fernández, César Aldecoa, Clara Bolaño-Pérez, Teresa Villán-González, Astrid Batalla, G. Azparren, M. Basttita, M. Felipe, L. Cueva, Marta Gine, A.M. Gómez-Caro, I. India, S. Piñol, Neus Esteve-Pérez, Carlos Mora-Fernández, Ana Ferrer-Robles, Juan J. Segura-Sampedro, Natalia Alonso-Hernández, Angels Camps-Cervantes, Ivette Chocrón-DA-Prat, Carolina C. Coronado-Silva, Héctor Duque-Santos, Elena Esclapez-Sempere, Patricia Galan-Menéndez, Silvia Matarín-Olmo, M.P. Tormos-Pérez, Laura Villarino-Villa, Héctor Bergés-Gutiérrez, Miguel Aisa-Gasca, Verónica Arbona-Camillero, José D. Bautista-González, Francisco J. Carballido-Pascual, Mercedes Gutiérrez-Moreno, Ana Muñoz-Durán, Jesús Cañete-Gómez, Esther Cáceres-Fabrega, José M. Lorente-Herce, Octavio Mulet-Zayas, Rocío Gómez-Pérez, Cristina Monje-Salazar, Luis Lobato-Bancalero, Carmelo Torres-Moreno, Elena Sanchez-Cárdenas, Juan J. Daza-González, Teresa Sanchez-Viguera, Antonio DEL-Fresno-Asensio, Laura Bermudez-Román, José L. Jover-Pinillos, Francisco J. Orts-Micó, Coral Cózar-Lozano, Olga Blasco-Delgado, Andrea Nonnemacher-SAN-Julián, José A. Pérez, Laura D.U.R.Á.N. Cruces, Pablo Renedo-Corcóstegui
Rok vydání: 2021
Předmět:
Zdroj: Journal of clinical anesthesia. 74
ISSN: 1873-4529
Popis: Adherence to Enhanced Recovery Protocols (ERPs) is associated with faster functional recovery, better patient satisfaction, lower complication rates and reduced length of hospital stay. Understanding institutional barriers and facilitators is essential for improving adherence to ERPs. The purpose of this study was to identify institutional factors associated with adherence to an ERP for colorectal surgery.A secondary analysis of a nationwide study was conducted including 686 patients who underwent colorectal surgery across twenty-one institutions in Spain. Adherence to ERPs was calculated based upon the components recommended by the Enhanced Recovery After Surgery (ERAS®) Society. Institutional characteristics (i.e., case volume, ERP duration, anesthesia staff size, multidisciplinary meetings, leadership discipline) were captured from each participating program. Multivariable regression was performed to determine characteristics associated with adherence.The median adherence to ERAS was 68.2% (IQR 59.1%-81.8%). Multivariable linear regression revealed that anesthesiologist leadership (+5.49%, 95%CI +2.81% to +8.18%, P 0.01), duration of ERAS implementation (+0.46% per year, 95%CI +0.06% to +0.86%, P 0.01) and the use of regular multidisciplinary meetings (+4.66%, 95%CI +0.06 to +7.74%, P 0.01) were independently associated with greater adherence. Case volume (-2.38% per 4 cases weekly, 95%CI -3.03 to -1.74, P 0.01) and number of anesthesia providers (-1.19% per 10 providers, 95%CI +2.23 to -8.18%, P 0.01) were negatively associated with adherence.Adherence to ERPs is strongly associated with anesthesiology leadership, regular multidisciplinary meetings, and program duration, whereas case volume and the size of the anesthesia staff were potential barriers. These findings highlight the importance of strong leadership, experience and establishing a multidisciplinary team when developing an ERP for colorectal surgery.
Databáze: OpenAIRE