Implementation of Enhanced Recovery After Surgery (ERAS) Across a Provincial Healthcare System: The ERAS Alberta Colorectal Surgery Experience

Autor: Lawrence N. Kiyang, Olle Ljungqvist, Tracy Wasylak, Gregg Nelson, Leah Gramlich, Anderson Chuck, Thanh X. Nguyen, Peter Faris, Carlota Basualdo-Hammond, Ellen Crumley, Susan McKay
Rok vydání: 2016
Předmět:
Zdroj: World Journal of Surgery. 40:1092-1103
ISSN: 1432-2323
0364-2313
DOI: 10.1007/s00268-016-3472-7
Popis: Enhanced recovery after surgery (ERAS) colorectal guideline implementation has occurred primarily in standalone institutions worldwide. We implemented the guideline in a single provincial healthcare system, and our study examined the effect of the guideline on patient outcomes [length of stay (LOS), complications, and 30-day post-discharge readmissions] across a healthcare system. We compared pre- and post-guideline implementation in consecutive elective colorectal patients, ≥18 years, from six Alberta hospitals between February 2013 and December 2014. Participants were followed up to 30 days post discharge. We used summary statistics, to assess the LOS and complications, and multivariate regression methods to assess readmissions and to estimate cost impacts. A total of 1333 patients (350 pre- and 983 post-ERAS) were analysed. Of this number, 55 % were males. Median overall guideline compliance was 39 % in pre- and 60 % in post-ERAS patients. Median LOS was 6 days for pre-ERAS compared to 4.5 days in post-ERAS patients with the longest implementation (p value
Databáze: OpenAIRE
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