Increased postoperative day one discharges after implementation of a hysterectomy enhanced recovery pathway: a retrospective cohort study

Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie
Elizabeth C MillerAnne Lui

Abstract

In 2011, the hysterectomy enhanced recovery (HER) pathway, a multi-disciplinary, evidence-based care plan designed to improve recovery after open gynecologic surgery for non-malignant lesions, was introduced at The Ottawa Hospital (TOH). This before-and-after study examined the impact of the HER pathway on postoperative day (POD) 1 hospital discharge. Ethical approval was obtained. This retrospective cohort study included patients who had undergone open abdominal gynecologic surgery for non-malignant lesions at TOH Civic Campus between July 2010 and September 2012 (the year before and year after HER implementation). Patients were analyzed in either a pre-HER or post-HER group depending on their surgery date. Patients with chronic pain and emergent surgery were excluded. Data were obtained via medical chart review. Our primary outcome was the percentage of POD 1 discharges before and after HER implementation. Secondary outcomes included return to hospital within 30 days of discharge, median length of stay (LOS), clinician compliance with HER, and an exploratory analysis with multivariable modelling to evaluate which aspects of the HER independently predicted POD 1 discharge. Variables used included American Society of Anesthesio...Continue Reading

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Citations

Feb 25, 2015·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Hilary P Grocott
Aug 16, 2016·Obstetrics and Gynecology Clinics of North America·Eleftheria Kalogera, Sean C Dowdy
Apr 24, 2020·Current Opinion in Obstetrics & Gynecology·Christine M HelouTed L Anderson
Jun 24, 2020·Journal of Robotic Surgery·Christine E FoleyJian Qun Huang
Dec 18, 2015·Obstetrical & Gynecological Survey·Emma L Barber, Linda Van Le
Jun 25, 2019·Female Pelvic Medicine & Reconstructive Surgery·Aisling A ClancyDuane R Hickling
Jun 18, 2021·Journal of Minimally Invasive Gynecology·Maria J SmithBhavana Pothuri

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