The Impact of Anesthesia-Influenced Process Measure Compliance on Length of Stay: Results From an Enhanced Recovery After Surgery for Colorectal Surgery Cohort

Anesthesia and Analgesia
Michael C GrantElizabeth C Wick

Abstract

Process measure compliance has been associated with improved outcomes in enhanced recovery after surgery (ERAS) programs. Herein, we sought to assess the impact of compliance with measures directly influenced by anesthesiology in an ERAS for colorectal surgery cohort. From January 2013 to April 2015, data from 1140 consecutive patients were collected for all patients before (pre-ERAS) and after (ERAS) implementation of an ERAS program. Compliance with 9 specific process measures directly influenced by the anesthesiologist or acute pain service was analyzed to determine the impact on hospital length of stay (LOS). Process measure compliance was associated with a stepwise reduction in LOS. Patients who received >4 process measures (high compliance) had a significantly shorter LOS (incident rate ratio [IRR], 0.77; 95% CI, 0.70-0.85); P < .001) compared to low compliance (0-2 process measures) counterparts. Multivariable regression suggests that utilization of multimodal nausea and vomiting prophylaxis (IRR, 0.78; 95% CI, 0.68-0.89; P < .001), scheduled postoperative nonsteroidal pain medication use (IRR, 0.76; 95% CI, 0.67-0.85; P < .001), and strict adherence to a postoperative opioid administration (IRR, 0.58; 95% CI, 0.51-0.67;...Continue Reading

References

Sep 4, 2012·International Journal of Colorectal Disease·Francesco FerociMarco Scatizzi
Oct 27, 2012·Clinical Nutrition : Official Journal of the European Society of Parenteral and Enteral Nutrition·U O GustafssonUNKNOWN Enhanced Recovery After Surgery Society
Dec 21, 2013·Anesthesia and Analgesia·Tong J GanUNKNOWN Society for Ambulatory Anesthesia
Sep 26, 2015·Joint Commission Journal on Quality and Patient Safety·Christopher L WuElizabeth C Wick
Mar 12, 2016·Anaesthesiology Intensive Therapy·Bartosz HoroszMałgorzata Malec-Milewska
Jun 17, 2016·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Etrusca BrogiThomas M Hemmerling
Jan 18, 2017·JAMA Surgery·Olle LjungqvistKenneth C Fearon

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Citations

Feb 12, 2020·Journal of Investigative Medicine : the Official Publication of the American Federation for Clinical Research·Jaclyn N Kline, Asha S Payne
May 10, 2020·Current Pain and Headache Reports·Alexander StoneRichard D Urman
Aug 14, 2020·Surgery Today·Andrés Zorrilla-VacaMichael C Grant
Feb 7, 2021·BMC Anesthesiology·Dan B EllisRachel Sisodia
Jun 2, 2021·Journal of Cardiothoracic and Vascular Anesthesia·Nadia B HensleyJames A Abernathy
Jun 19, 2021·Journal of Clinical Anesthesia·Andres Zorrilla-VacaUNKNOWN Power Investigators Group (including all Researchers participating in POWER Study)

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