Association of Enhanced Recovery Pathway Compliance With Patient Outcomes

Abstract

Enhanced recovery pathways (ERPs) have emerged as one of the most effective strategies to improve clinical outcomes and reduce health care utilization in elective colorectal surgery. However, ERP implementation alone does not result in improvement without high pathway component compliance. 1,2 Hospital collaboratives have been used to accelerate quality improvement across clinical areas, including ERP adoption. [3][4][5] Despite collaborative participation, hospitals are frequently hindered by barriers related to local culture, agreement over ERP components, and resources.The question remains if patients can achieve equally efficacious outcomes regardless of local hospital culture. We sought to determine the association of high ERP compliance with patient outcomes in the setting of variation in hospitallevel performance in a national ERP collaborative.

Supportive Care Needs of Patients With Temporary Ostomy in Enhanced Recovery After Surgery: A Mixed-Methods Study

“…These changes, especially related to the substantially reduced hospitalization durations, disrupt standard care plans and generate new patient care demands. In addition, most existing ERAS programs are based on expert consensus and lack consideration of the patient perspective, undermining patient compliance rates and intervention effects (Fischer et al, 2021; Forsmo et al, 2016). The care requirements of patients under the new ERAS paradigm have yet to be extensively studied.…”

Enhanced Recovery in an Ambulatory Surgical Oncology Center: The Tip of the Scalpel

“…3,5,6 Not surprisingly, the advent of more multifaceted and thus complicated ERAS programs and protocols have often hampered their success. 3,6,7 There is an increasing opportunity and impetus for ambulatory surgery with extended recovery, in which patients are admitted, operated on, and stay for 1 night postoperatively, with an overall stay up to 23 hours. 6 It has been reported that total knee arthroplasty can be performed safely as an outpatient procedure in a subset of healthy patients 65 years or older, with a complication rate similar to an inpatient stay.…”

“…3,5,6 Not surprisingly, the advent of more multifaceted and thus complicated ERAS programs and protocols have often hampered their success. 3,6,7…”

“…3 Thus, there is an impetus to simplify ERAS protocols by identifying the core components for their effectiveness. 7 Most agree that the use of a minimally invasive surgical approach is critical, as it reduces the surgical stress response—the original, fundamental basis for introducing the ERAS concept. 1 Other components that are important for improving patient-related outcomes include preoperative patient education and engagement; fast-track anesthetic technique, including PONV prophylaxis with at least 2 to 3 antiemetics irrespective of risk status; multimodal, opioid-sparing pain management; early oral intake; and early ambulation.…”