| Title |
Implementation of Enhanced Recovery After Surgery (ERAS) Across a Provincial Healthcare System: The ERAS Alberta Colorectal Surgery Experience
|
|---|---|
| Published in |
World Journal of Surgery, February 2016
|
| DOI | 10.1007/s00268-016-3472-7 |
| Pubmed ID | |
| Authors |
Gregg Nelson, Lawrence N. Kiyang, Ellen T. Crumley, Anderson Chuck, Thanh Nguyen, Peter Faris, Tracy Wasylak, Carlota Basualdo‐Hammond, Susan McKay, Olle Ljungqvist, Leah M. Gramlich |
| Abstract |
Enhanced recovery after surgery (ERAS) colorectal guideline implementation has occurred primarily in standalone institutions worldwide. We implemented the guideline in a single provincial healthcare system, and our study examined the effect of the guideline on patient outcomes [length of stay (LOS), complications, and 30-day post-discharge readmissions] across a healthcare system. We compared pre- and post-guideline implementation in consecutive elective colorectal patients, ≥18 years, from six Alberta hospitals between February 2013 and December 2014. Participants were followed up to 30 days post discharge. We used summary statistics, to assess the LOS and complications, and multivariate regression methods to assess readmissions and to estimate cost impacts. A total of 1333 patients (350 pre- and 983 post-ERAS) were analysed. Of this number, 55 % were males. Median overall guideline compliance was 39 % in pre- and 60 % in post-ERAS patients. Median LOS was 6 days for pre-ERAS compared to 4.5 days in post-ERAS patients with the longest implementation (p value <0.0001). Adjusted risk ratio (RR) was 1.71, 95 % CI 1.09-2.68 for 30-day readmission, comparing pre- to post-ERAS patients. The proportion of patients who developed at least one complication was significantly reduced, from pre- to post-ERAS, difference in proportions = 11.7 %, 95 % CI 2.5-21.0, p value: 0.0139. The net cost savings attributable to guideline implementation ranged between $2806 and $5898 USD per patient. The findings in our study have shown that ERAS colorectal guideline implementation within a healthcare system resulted in patient outcome improvements, similar to those obtained in smaller standalone implementations. There was a significant beneficial impact of ERAS on scarce health system resources. |
X Demographics
The data shown below were collected from the profiles of 2 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Canada | 1 | 50% |
| Sweden | 1 | 50% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Scientists | 1 | 50% |
| Science communicators (journalists, bloggers, editors) | 1 | 50% |
Mendeley readers
The data shown below were compiled from readership statistics for 151 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 151 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Other | 17 | 11% |
| Student > Master | 17 | 11% |
| Researcher | 15 | 10% |
| Student > Bachelor | 15 | 10% |
| Professor > Associate Professor | 12 | 8% |
| Other | 38 | 25% |
| Unknown | 37 | 25% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 69 | 46% |
| Nursing and Health Professions | 13 | 9% |
| Agricultural and Biological Sciences | 4 | 3% |
| Social Sciences | 3 | 2% |
| Business, Management and Accounting | 2 | 1% |
| Other | 13 | 9% |
| Unknown | 47 | 31% |
Attention Score in Context
This research output has an Altmetric Attention Score of 2. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 05 March 2016.
All research outputs
#14,252,067
of 22,852,911 outputs
Outputs from World Journal of Surgery
#2,766
of 4,232 outputs
Outputs of similar age
#156,521
of 297,594 outputs
Outputs of similar age from World Journal of Surgery
#26
of 53 outputs
Altmetric has tracked 22,852,911 research outputs across all sources so far. This one is in the 35th percentile – i.e., 35% of other outputs scored the same or lower than it.
So far Altmetric has tracked 4,232 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 6.6. This one is in the 31st percentile – i.e., 31% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 297,594 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 44th percentile – i.e., 44% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 53 others from the same source and published within six weeks on either side of this one. This one is in the 49th percentile – i.e., 49% of its contemporaries scored the same or lower than it.