Enhanced Recovery After Surgery in Colorectal Surgery: A Large-Scale Quality Improvement Project (ERAS)

Vanderbilt University Medical Center

Status: Completed

Conditions: ERAS; Quality Improvement; Perioperative Care; Colorectal Surgery

Treatments: Procedure: Noninvasive hemodynamic monitoring; Procedure: ERAS perioperative care; Procedure: Standard perioperative care

Study type: Observational

Funder types: Other; Industry

Identifiers

NCT03189550

140558

Details and patient eligibility

About

Multimodal perioperative care pathways have evolved into enhanced recovery after surgery (ERAS). ERAS pathways improve the quality of patient care, reduce morbidity, and shorten length of stay. This project will test the hypothesis that implementation of a multi-modal ERAS perioperative care protocol in colorectal surgical patients will result in significantly reduced perioperative morbidity and mortality.

Full description

Multimodal perioperative care pathways have evolved into enhanced recovery after surgery (ERAS). ERAS pathways improve the quality of patient care, reduce morbidity, and shorten length of stay. This large quality improvement project will compare outcomes after standard perioperative practice with those after the implementation of a multi-modal evidence based care pathway, including standardized preoperative preparation, perioperative goal-directed fluid therapy (GFDT), multi-modal perioperative pain management, post operative nausea and vomiting prevention, surgical care and bowel isolation, and surgical site infection prevention. This project will test the hypothesis that implementation of a multi-modal ERAS perioperative care protocol in colorectal surgical patients will result in significantly reduced perioperative morbidity and mortality.

Enrollment: 664 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• All patients who underwent colorectal surgery at Vanderbilt University Medical Center and whose data is stored in the perioperative data warehouse.

Exclusion criteria

• Age <18 years
• Weight <40 kg

Trial design

664 participants in 3 patient groups

Historical control

Description:

Patients who underwent colorectal surgery with standard perioperative care starting from June 2014 and progressing backward in time.

Treatment:

Procedure: Standard perioperative care

ERAS without SOC noninvasive hemodynamic monitoring

Description:

Patients who underwent colorectal surgery after implementation of standard of care (SOC) ERAS perioperative care from July 2014 to February 2015

Treatment:

Procedure: ERAS perioperative care

Procedure: Standard perioperative care

ERAS with SOC noninvasive hemodynamic monitoring

Description:

Patients who underwent colorectal surgery after implementation of standard of care ERAS perioperative care with standard of care noninvasive hemodynamic monitoring (with the ClearSight System, Edwards Lifesciences) after February 2015

Treatment:

Procedure: ERAS perioperative care

Procedure: Noninvasive hemodynamic monitoring

Procedure: Standard perioperative care