Liver Transplant Fast-Track With an Emphasis on Reduced Delirium: A Multidisciplinary Approach to Reducing Length of Stay.

Enhanced recovery after surgery protocols have been shown to reduce length of stay in transplant patients. The purpose of our study was to evaluate the impact of a standardized protocol in liver transplant recipients (LTR) on length of stay (LOS) and delirium during the index hospitalization post-LT. Elements of the protocol included reduced intraoperative corticosteroids (from methylprednisolone 1000 to 250 mg), conversion of steroid taper to be administered once-daily instead of BID, optimal end-of-case intraoperative extubation, multimodal analgesia, early removal of surgical drains, implementation of dietary and physical therapy plans and education for multidisciplinary providers and patients about expected LOS.

Non-physician practitioners' overall enhancement to a surgical resident's experience.

Purpose: The Mount Sinai Surgical Residency program uses physician assistants and nurse practitioners, jointly termed non-physician practitioners (NPPs), to adhere to the 80-hour work-week restrictions implemented by Accreditation Council of Graduate Medical Education (ACGME) resident duty hour requirements initiated in 2003. A survey was performed to determine how the integration of NPPs into the surgical subspecialty teams has affected surgical residents' perceptions of their education and overall residency experience. We review the roles of NPPs within surgical specialty teams as well as our survey findings about NPP and resident impressions about the NPP role.