Outcomes of Patients Undergoing Elective Bowel Resection Before and After Implementation of an Anemia Screening and Treatment Program

Abstract

BACKGROUND:Patients with anemia undergoing elective colorectal cancer surgery are known to have significantly higher rates of postoperative complications and worse outcomes. OBJECTIVE:This study aimed to improve rates of anemia screening and treatment in patients undergoing elective colon and rectal resections through a quality improvement initiative. DESIGN:We compared a historical cohort of patients before implementation of our anemia screening and treatment quality improvement program to a prospective cohort after implementation. SETTINGS:This study was conducted at a tertiary care hospital. PATIENTS:This study included all adult patients with a new diagnosis of colon or rectal cancer without evidence of metastatic disease between 2017 and 2019. INTERVENTIONS:The interventions include the anemia screening and treatment quality improvement program. MAIN OUTCOME MEASURES:The primary outcome was hospital cost per admission. RESULTS:This study includes a total of 84 patients who underwent elective colon or rectal resection before See editorial on page 1293.

Providing Value to Patients: Operating Outside the Bubble

“…Viewed through the lens of a system-level improvement measure and the individual patient, one might argue that the gains in the Gilbert et al’ 6 study were modest. Readmissions decreased, but there were no observable differences in hemoglobin levels, transfusions, complications, or any other parameter one might expect from a program designed to target anemia.…”