A system-wide enhanced recovery program focusing on two key process steps reduces complications and readmissions in patients undergoing bowel surgery

Journal for Healthcare Quality

Volumn 39, Issue 3, 2017, Pages 129-135

  Loftus, Terrence J ^a   Stelton, Susan ^a   Efaw, Brett W ^a   Bloomstone, Joshua ^b  

^a BANNER HEALTH   (United States)

^b Banner Thunderbird Medical Center   (United States)

Author keywords

Care management; Integrated health; Knowledge; Management; Process design; Quality improvement; System

Indexed keywords

ALVIMOPAN;

ADULT; ARTICLE; ARTIFICIAL FEEDING; CLINICAL OUTCOME; COHORT ANALYSIS; DIGESTIVE SYSTEM INJURY; ELECTIVE SURGERY; ENHANCED RECOVERY PROGRAM; EVIDENCE BASED PRACTICE; FEMALE; HEALTH CARE QUALITY; HOSPITAL READMISSION; HUMAN; INTEGRATED HEALTH CARE SYSTEM; INTESTINE SURGERY; LAPAROSCOPIC SURGERY; LARGE INTESTINE; LUNG COMPLICATION; MAJOR CLINICAL STUDY; MALE; MIDDLE AGED; MOBILIZATION; MORTALITY RATE; OPERATION DURATION; POSTOPERATIVE COMPLICATION; POSTOPERATIVE ILEUS; PRACTICE GUIDELINE; RETROSPECTIVE STUDY; SMALL INTESTINE; SURGICAL MORTALITY; SURGICAL PATIENT; WOUND ASSESSMENT; COMPLICATION; DIGESTIVE FUNCTION; INFLAMMATORY BOWEL DISEASE; LENGTH OF STAY; POSTANESTHESIA NURSING; STANDARDS; STATISTICS AND NUMERICAL DATA; URINARY TRACT FUNCTION;

ADULT; DIGESTIVE SYSTEM PHYSIOLOGICAL PHENOMENA; EARLY AMBULATION; FEMALE; HUMANS; INFLAMMATORY BOWEL DISEASES; LENGTH OF STAY; MALE; MIDDLE AGED; PATIENT READMISSION; POSTANESTHESIA NURSING; POSTOPERATIVE COMPLICATIONS; PRACTICE GUIDELINES AS TOPIC; URINARY TRACT PHYSIOLOGICAL PHENOMENA;

EID: 85020313783     PISSN: 10622551     EISSN: 19451474     Source Type: Journal    
DOI: 10.1111/jhq.12068     Document Type: Article

References (15)

1. Abraham N, Albayati S. Enhanced recovery after surgery programs hastens recovery after colorectal resections. World Journal of Gastrointestinal Surgery 2011;3:1-6.
2. Burdick T, Elco J, Sexton L. Achieving a shared baseline: Implementing evidence based clinical practices. Presented at the 20th Annual Society for Health Systems Conference, Orlando, FL, February 24, 2008. 2008.
3. Delaney C, Craver C, Gibbons MM, Rachfal AW, VandePol CJ, Cook SF, et al. Evaluation of clinical outcomes with alvimopan in clinical practice: A national matched-cohort study in patients undergoing bowel resection. Annals of Surgery 2012;255:731-738.
4. Delaney CP, Wolff BG, Viscusi ER, Senagore AJ, Fort JG, Du W, et al. Alvimopan, for post-operative ileus following bowel resection: A pooled analysis of phase III studies. Annals of Surgery 2007;245:355-363.
5. Donohoe CL, Nguyen M, Cook J, Murray SG, Chen N, Zaki F, et al. Fast-track protocols in colorectal surgery. The Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland 2011;9:95-103.
6. Krames Stay Well, LLC. Bowel surgery: Your preparation, procedure and recovery. Krames Patient Education. A MediMedia Company, Yardley, PA, 2011.
7. Larson DW, Batdorf NJ, Tourzios JG, Cima RR, Chua HK, Pemberton JH, et al. A fast-track recovery protocol improves outcomes in elective laparoscopic colectomy for divertic-ulitis. Journal of the American College of Surgeons 2010;211:485-489.
8. Lassen K, Soop M, Nygren J, Cox PB, Hendry PO, Spies C, et al. Consensus review of optimal perioperative care in colorectal surgery: Enhanced Recovery After Surgery (ERAS) Group recommendations. Archives of Surgery 2009;144:961-969.
9. Lloyd GM, Kirby R, Hemingway DM, Keane FB, Miller AS, Neary P. The RAPID protocol en-hances patient recovery after both laparoscopic and open colorectal resections. Surgical Endos-copy 2010;24:1434-1439.
10. Ludwig K, Enker WE, Delaney CP, Wolff BG, Du W, Fort JG, et al. Gastrointestinal tract recovery in patients undergoing bowel resection: Results of a randomized trial of alvimopan and placebo with a standardized accelerated postoperative care pathway. Archives of Surgery 2008;143:1098-1105.
11. Polle SW, Wind J, Fuhring JW, Hofland J, Gouma DJ, Bemelman WA. Implementation of a fast-track perioperative care program: What are the difficulties? Digestive Surgery 2007;24:441-449.
12. Rogers EM. Diffusion of innovations. New York: Free Press, 2003.
13. Varadhan KK, Neal KR, Dejong CH, Fearon KC, Ljungqvist O, Lobo DN. The enhanced recovery after surgery (ERAS) pathway for patients undergoing major elective open colorectal surgery: A meta-analysis of ran-domized controlled trials. Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition 2010;29:434-440.
14. Vlug MS, Wind J, Hollmann MW, Ubbink DT, Cense HA, Engel AF, et al. LAFA study group. Laparoscopy in combination with fast track multimodal management is the best perioperative strategy in patients undergoing colonic surgery: A randomized clinical trial (LAFA-study). Annals of Surgery 2011;254:868-875.
15. Wolff BG, Michelassi F, Gerkin TM, Techner L, Gabriel K, Du W, et al. Alvimopan, a novel, peripherally acting mu opioid antagonist: Results of a multicenter, randomized, double-blind, placebo-controlled, phase III trial of major abdominal surgery and postoperative ileus. Annals of Surgery 2004;240:728-734; dis-cussion 734-735.