Impact of Multidisciplinary Audit of Enhanced Recovery After Surgery (ERAS)® Programs at a Single Institution
Background As Enhanced Recovery After Surgery (ERAS®) programs expand across numerous subspecialties, growth and sustainability on a system level becomes increasingly important and may benefit from reporting multidisciplinary and financial data. However, the literature on multidisciplinary outcome a...
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| Veröffentlicht in: | World journal of surgery 2021, Vol.45 (1), p.23-32 |
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| creator | Pickens, Ryan C. Cochran, Allyson R. Lyman, William B. King, Lacey Iannitti, David A. Martinie, John B. Baker, Erin H. Ocuin, Lee M. Riggs, Stephen B. Davis, Bradley R. Matthews, Brent D. Vrochides, Dionisios |
| description | Background
As Enhanced Recovery After Surgery (ERAS®) programs expand across numerous subspecialties, growth and sustainability on a system level becomes increasingly important and may benefit from reporting multidisciplinary and financial data. However, the literature on multidisciplinary outcome analysis in ERAS is sparse. This study aims to demonstrate the impact of multidisciplinary ERAS auditing in a hospital system. Additionally, we describe developing a financial metric for use in gaining support for system-wide ERAS adoption and sustainability.
Methods
Data from HPB, colorectal and urology ERAS programs at a single institution were analyzed from a prospective ERAS Interactive Audit System (EIAS) database from September 2015 to June 2019. Clinical 30-day outcomes for the ERAS cohort (
n
= 1374) were compared to the EIAS pre-ERAS control (
n
= 311). Association between improved ERAS compliance and improved outcomes were also assessed for the ERAS cohort. The potential multidisciplinary financial impact was estimated from hospital bed charges.
Results
Multidisciplinary auditing demonstrated a significant reduction in postoperative length of stay (LOS) (1.5 days,
p
|
| doi_str_mv | 10.1007/s00268-020-05765-y |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2440470720</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2473368112</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4268-4370c0251289724ee4c41881e71b042fcd3c856441414b487f9fc7b2c536f6703</originalsourceid><addsrcrecordid>eNqNkc1O3DAUha0KVKbQF2CBLLGhi9Drn9imuyka2kFUIKYVSyvjOINR4gx20mpeqg_RJ6tDKEgsKuSFbd3vHN17D0L7BI4JgPwYAahQGVDIIJcizzZv0IRwRjPKKNtCE2CCpzdhO-hdjHcARAoQb9EOo0oJIsQE-XmzLkyH2wp_6-vOlS4at66dL8IGT_vSPZRm_rbwxpb42pr2px1KVWcDXvRhNfyOZtfTxYc_v_FVaFehaCIuOlzghfOr2uK5j53r-s61fg9tV0Ud7fvHexf9OJt9P_2aXVx-mZ9OLzLDh5E4k2CA5oSqE0m5tdxwohSxkiyB08qUzKhccE7SWXIlq5PKyCU1OROVkMB20dHouw7tfW9jp5s0mK3rwtu2j5pyDlyCpAN6-AK9a_vgU3eJkowJRQhNFB0pE9oYg630OrgmLUkT0EMaekxDpzT0Qxp6k0QHj9b9srHlk-Tf-hPwaQR-udpuXmGpb84Xn89STakkZqM4Jp1POTw3_p-e_gJ-paV3</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2473368112</pqid></control><display><type>article</type><title>Impact of Multidisciplinary Audit of Enhanced Recovery After Surgery (ERAS)® Programs at a Single Institution</title><source>Wiley Journals</source><source>SpringerLink Journals - AutoHoldings</source><creator>Pickens, Ryan C. ; Cochran, Allyson R. ; Lyman, William B. ; King, Lacey ; Iannitti, David A. ; Martinie, John B. ; Baker, Erin H. ; Ocuin, Lee M. ; Riggs, Stephen B. ; Davis, Bradley R. ; Matthews, Brent D. ; Vrochides, Dionisios</creator><creatorcontrib>Pickens, Ryan C. ; Cochran, Allyson R. ; Lyman, William B. ; King, Lacey ; Iannitti, David A. ; Martinie, John B. ; Baker, Erin H. ; Ocuin, Lee M. ; Riggs, Stephen B. ; Davis, Bradley R. ; Matthews, Brent D. ; Vrochides, Dionisios</creatorcontrib><description>Background
As Enhanced Recovery After Surgery (ERAS®) programs expand across numerous subspecialties, growth and sustainability on a system level becomes increasingly important and may benefit from reporting multidisciplinary and financial data. However, the literature on multidisciplinary outcome analysis in ERAS is sparse. This study aims to demonstrate the impact of multidisciplinary ERAS auditing in a hospital system. Additionally, we describe developing a financial metric for use in gaining support for system-wide ERAS adoption and sustainability.
Methods
Data from HPB, colorectal and urology ERAS programs at a single institution were analyzed from a prospective ERAS Interactive Audit System (EIAS) database from September 2015 to June 2019. Clinical 30-day outcomes for the ERAS cohort (
n
= 1374) were compared to the EIAS pre-ERAS control (
n
= 311). Association between improved ERAS compliance and improved outcomes were also assessed for the ERAS cohort. The potential multidisciplinary financial impact was estimated from hospital bed charges.
Results
Multidisciplinary auditing demonstrated a significant reduction in postoperative length of stay (LOS) (1.5 days,
p
< 0.001) for ERAS patients in aggregate and improved ERAS compliance was associated with reduced LOS (coefficient − 0.04,
p
= 0.004). Improved ERAS compliance in aggregate also significantly associated with improved 30-day survival (odds ratio 1.04,
p
= 0.001). Multidisciplinary analysis also demonstrated a potential financial impact of 44% savings (
p
< 0.001) by reducing hospital bed charges across all specialties.
Conclusions
Multidisciplinary auditing of ERAS programs may improve ERAS program support and expansion. Analysis across subspecialties demonstrated associations between improved ERAS compliance and postoperative LOS as well as 30-day survival, and further suggested a substantial combined financial impact.</description><identifier>ISSN: 0364-2313</identifier><identifier>EISSN: 1432-2323</identifier><identifier>DOI: 10.1007/s00268-020-05765-y</identifier><identifier>PMID: 32886166</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Abdominal Surgery ; Auditing ; Cardiac Surgery ; Compliance ; General Surgery ; Interactive systems ; Medicine ; Medicine & Public Health ; Original Scientific Report ; Recovery ; Recovery (Medical) ; Surgery ; Survival ; Sustainability ; Thoracic Surgery ; Urology ; Vascular Surgery</subject><ispartof>World journal of surgery, 2021, Vol.45 (1), p.23-32</ispartof><rights>Société Internationale de Chirurgie 2020</rights><rights>2021 The Author(s) under exclusive licence to Société Internationale de Chirurgie</rights><rights>Société Internationale de Chirurgie 2020.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4268-4370c0251289724ee4c41881e71b042fcd3c856441414b487f9fc7b2c536f6703</citedby><cites>FETCH-LOGICAL-c4268-4370c0251289724ee4c41881e71b042fcd3c856441414b487f9fc7b2c536f6703</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00268-020-05765-y$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00268-020-05765-y$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,41488,42557,45574,45575,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32886166$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Pickens, Ryan C.</creatorcontrib><creatorcontrib>Cochran, Allyson R.</creatorcontrib><creatorcontrib>Lyman, William B.</creatorcontrib><creatorcontrib>King, Lacey</creatorcontrib><creatorcontrib>Iannitti, David A.</creatorcontrib><creatorcontrib>Martinie, John B.</creatorcontrib><creatorcontrib>Baker, Erin H.</creatorcontrib><creatorcontrib>Ocuin, Lee M.</creatorcontrib><creatorcontrib>Riggs, Stephen B.</creatorcontrib><creatorcontrib>Davis, Bradley R.</creatorcontrib><creatorcontrib>Matthews, Brent D.</creatorcontrib><creatorcontrib>Vrochides, Dionisios</creatorcontrib><title>Impact of Multidisciplinary Audit of Enhanced Recovery After Surgery (ERAS)® Programs at a Single Institution</title><title>World journal of surgery</title><addtitle>World J Surg</addtitle><addtitle>World J Surg</addtitle><description>Background
As Enhanced Recovery After Surgery (ERAS®) programs expand across numerous subspecialties, growth and sustainability on a system level becomes increasingly important and may benefit from reporting multidisciplinary and financial data. However, the literature on multidisciplinary outcome analysis in ERAS is sparse. This study aims to demonstrate the impact of multidisciplinary ERAS auditing in a hospital system. Additionally, we describe developing a financial metric for use in gaining support for system-wide ERAS adoption and sustainability.
Methods
Data from HPB, colorectal and urology ERAS programs at a single institution were analyzed from a prospective ERAS Interactive Audit System (EIAS) database from September 2015 to June 2019. Clinical 30-day outcomes for the ERAS cohort (
n
= 1374) were compared to the EIAS pre-ERAS control (
n
= 311). Association between improved ERAS compliance and improved outcomes were also assessed for the ERAS cohort. The potential multidisciplinary financial impact was estimated from hospital bed charges.
Results
Multidisciplinary auditing demonstrated a significant reduction in postoperative length of stay (LOS) (1.5 days,
p
< 0.001) for ERAS patients in aggregate and improved ERAS compliance was associated with reduced LOS (coefficient − 0.04,
p
= 0.004). Improved ERAS compliance in aggregate also significantly associated with improved 30-day survival (odds ratio 1.04,
p
= 0.001). Multidisciplinary analysis also demonstrated a potential financial impact of 44% savings (
p
< 0.001) by reducing hospital bed charges across all specialties.
Conclusions
Multidisciplinary auditing of ERAS programs may improve ERAS program support and expansion. Analysis across subspecialties demonstrated associations between improved ERAS compliance and postoperative LOS as well as 30-day survival, and further suggested a substantial combined financial impact.</description><subject>Abdominal Surgery</subject><subject>Auditing</subject><subject>Cardiac Surgery</subject><subject>Compliance</subject><subject>General Surgery</subject><subject>Interactive systems</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Original Scientific Report</subject><subject>Recovery</subject><subject>Recovery (Medical)</subject><subject>Surgery</subject><subject>Survival</subject><subject>Sustainability</subject><subject>Thoracic Surgery</subject><subject>Urology</subject><subject>Vascular Surgery</subject><issn>0364-2313</issn><issn>1432-2323</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNqNkc1O3DAUha0KVKbQF2CBLLGhi9Drn9imuyka2kFUIKYVSyvjOINR4gx20mpeqg_RJ6tDKEgsKuSFbd3vHN17D0L7BI4JgPwYAahQGVDIIJcizzZv0IRwRjPKKNtCE2CCpzdhO-hdjHcARAoQb9EOo0oJIsQE-XmzLkyH2wp_6-vOlS4at66dL8IGT_vSPZRm_rbwxpb42pr2px1KVWcDXvRhNfyOZtfTxYc_v_FVaFehaCIuOlzghfOr2uK5j53r-s61fg9tV0Ud7fvHexf9OJt9P_2aXVx-mZ9OLzLDh5E4k2CA5oSqE0m5tdxwohSxkiyB08qUzKhccE7SWXIlq5PKyCU1OROVkMB20dHouw7tfW9jp5s0mK3rwtu2j5pyDlyCpAN6-AK9a_vgU3eJkowJRQhNFB0pE9oYg630OrgmLUkT0EMaekxDpzT0Qxp6k0QHj9b9srHlk-Tf-hPwaQR-udpuXmGpb84Xn89STakkZqM4Jp1POTw3_p-e_gJ-paV3</recordid><startdate>2021</startdate><enddate>2021</enddate><creator>Pickens, Ryan C.</creator><creator>Cochran, Allyson R.</creator><creator>Lyman, William B.</creator><creator>King, Lacey</creator><creator>Iannitti, David A.</creator><creator>Martinie, John B.</creator><creator>Baker, Erin H.</creator><creator>Ocuin, Lee M.</creator><creator>Riggs, Stephen B.</creator><creator>Davis, Bradley R.</creator><creator>Matthews, Brent D.</creator><creator>Vrochides, Dionisios</creator><general>Springer International Publishing</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>2021</creationdate><title>Impact of Multidisciplinary Audit of Enhanced Recovery After Surgery (ERAS)® Programs at a Single Institution</title><author>Pickens, Ryan C. ; Cochran, Allyson R. ; Lyman, William B. ; King, Lacey ; Iannitti, David A. ; Martinie, John B. ; Baker, Erin H. ; Ocuin, Lee M. ; Riggs, Stephen B. ; Davis, Bradley R. ; Matthews, Brent D. ; Vrochides, Dionisios</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4268-4370c0251289724ee4c41881e71b042fcd3c856441414b487f9fc7b2c536f6703</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Abdominal Surgery</topic><topic>Auditing</topic><topic>Cardiac Surgery</topic><topic>Compliance</topic><topic>General Surgery</topic><topic>Interactive systems</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Original Scientific Report</topic><topic>Recovery</topic><topic>Recovery (Medical)</topic><topic>Surgery</topic><topic>Survival</topic><topic>Sustainability</topic><topic>Thoracic Surgery</topic><topic>Urology</topic><topic>Vascular Surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Pickens, Ryan C.</creatorcontrib><creatorcontrib>Cochran, Allyson R.</creatorcontrib><creatorcontrib>Lyman, William B.</creatorcontrib><creatorcontrib>King, Lacey</creatorcontrib><creatorcontrib>Iannitti, David A.</creatorcontrib><creatorcontrib>Martinie, John B.</creatorcontrib><creatorcontrib>Baker, Erin H.</creatorcontrib><creatorcontrib>Ocuin, Lee M.</creatorcontrib><creatorcontrib>Riggs, Stephen B.</creatorcontrib><creatorcontrib>Davis, Bradley R.</creatorcontrib><creatorcontrib>Matthews, Brent D.</creatorcontrib><creatorcontrib>Vrochides, Dionisios</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Immunology Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>World journal of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Pickens, Ryan C.</au><au>Cochran, Allyson R.</au><au>Lyman, William B.</au><au>King, Lacey</au><au>Iannitti, David A.</au><au>Martinie, John B.</au><au>Baker, Erin H.</au><au>Ocuin, Lee M.</au><au>Riggs, Stephen B.</au><au>Davis, Bradley R.</au><au>Matthews, Brent D.</au><au>Vrochides, Dionisios</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impact of Multidisciplinary Audit of Enhanced Recovery After Surgery (ERAS)® Programs at a Single Institution</atitle><jtitle>World journal of surgery</jtitle><stitle>World J Surg</stitle><addtitle>World J Surg</addtitle><date>2021</date><risdate>2021</risdate><volume>45</volume><issue>1</issue><spage>23</spage><epage>32</epage><pages>23-32</pages><issn>0364-2313</issn><eissn>1432-2323</eissn><abstract>Background
As Enhanced Recovery After Surgery (ERAS®) programs expand across numerous subspecialties, growth and sustainability on a system level becomes increasingly important and may benefit from reporting multidisciplinary and financial data. However, the literature on multidisciplinary outcome analysis in ERAS is sparse. This study aims to demonstrate the impact of multidisciplinary ERAS auditing in a hospital system. Additionally, we describe developing a financial metric for use in gaining support for system-wide ERAS adoption and sustainability.
Methods
Data from HPB, colorectal and urology ERAS programs at a single institution were analyzed from a prospective ERAS Interactive Audit System (EIAS) database from September 2015 to June 2019. Clinical 30-day outcomes for the ERAS cohort (
n
= 1374) were compared to the EIAS pre-ERAS control (
n
= 311). Association between improved ERAS compliance and improved outcomes were also assessed for the ERAS cohort. The potential multidisciplinary financial impact was estimated from hospital bed charges.
Results
Multidisciplinary auditing demonstrated a significant reduction in postoperative length of stay (LOS) (1.5 days,
p
< 0.001) for ERAS patients in aggregate and improved ERAS compliance was associated with reduced LOS (coefficient − 0.04,
p
= 0.004). Improved ERAS compliance in aggregate also significantly associated with improved 30-day survival (odds ratio 1.04,
p
= 0.001). Multidisciplinary analysis also demonstrated a potential financial impact of 44% savings (
p
< 0.001) by reducing hospital bed charges across all specialties.
Conclusions
Multidisciplinary auditing of ERAS programs may improve ERAS program support and expansion. Analysis across subspecialties demonstrated associations between improved ERAS compliance and postoperative LOS as well as 30-day survival, and further suggested a substantial combined financial impact.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>32886166</pmid><doi>10.1007/s00268-020-05765-y</doi><tpages>10</tpages></addata></record> |
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| ispartof | World journal of surgery, 2021, Vol.45 (1), p.23-32 |
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| language | eng |
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| source | Wiley Journals; SpringerLink Journals - AutoHoldings |
| subjects | Abdominal Surgery Auditing Cardiac Surgery Compliance General Surgery Interactive systems Medicine Medicine & Public Health Original Scientific Report Recovery Recovery (Medical) Surgery Survival Sustainability Thoracic Surgery Urology Vascular Surgery |
| title | Impact of Multidisciplinary Audit of Enhanced Recovery After Surgery (ERAS)® Programs at a Single Institution |
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