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.
journal_name
BMC Health Serv Resjournal_title
BMC health services researchauthors
Smucker L,Victory J,Scribani M,Oceguera L,Monzon Rdoi
10.1186/s12913-020-05971-3subject
Has Abstractpub_date
2020-12-03 00:00:00pages
1120issue
1issn
1472-6963pii
10.1186/s12913-020-05971-3journal_volume
20pub_type
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