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Rural context, single institution prospective outcomes after enhanced recovery colorectal surgery protocol implementation. | LitMetric

AI Article Synopsis

  • Rural hospitals struggle to adopt Enhanced Recovery protocols for colorectal surgeries, with limited successful examples and few outcome-based trials in the U.S.
  • A study analyzed elective bowel resection data before and after implementing an ERAS protocol, finding a significant reduction in hospital stay and costs without changing readmission or complication rates.
  • The findings suggest that addressing rural-specific barriers with tailored organizational strategies can help sustain effective Enhanced Recovery practices.

Article Abstract

Background: Rural hospitals face unique challenges to adopting Enhanced Recovery protocols after colorectal surgical procedures. There are few examples of successful implementation in the United States, and fewer yet of prospective, outcomes-based trials.

Methods: This study drew data from elective bowel resection prospectively collected, retrospectively analyzed cases 2 years prior (n = 214) and 3 years after (n = 224) implementing an ERAS protocol at a small, rural health network in upstate New York. Primary outcomes were cost, length-of-stay, readmission rate, and complications.

Results: The implementation required changes and buy-in at multiple levels of the institution. There was a statistically significant reduction in mean length of stay (6.9 versus 5.1 days) and per-patient savings to hospital ($3000) after implementation of ERAS protocol. There was no significant change in rate of 30-day readmissions or complications.

Conclusions: The authors conclude that for rural-specific barriers to implementation of Enhanced Recovery protocols there are specific organizational strategies that can ultimately yield sustainable endpoints.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7712524PMC
http://dx.doi.org/10.1186/s12913-020-05971-3DOI Listing

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