Background: Barriers exist in implementing enhanced recovery after surgery (ERAS), which aims to decrease postoperative complication rates and length of stay, because perioperative care is varied and compliance from a multidisciplinary team is critical to success. The objectives of this project were to evaluate the effectiveness of the National Surgical Quality Improvement Program (NSQIP) database as a tool for the ongoing assessment of outcomes associated with ERAS and to evaluate ERAS as a quality-improvement strategy at a hospital-wide level.Methods: Adult patients who underwent an elective colorectal procedure at The Ottawa Hospital between March 2010 and September 2015 were included. Information on demographic characteristics, functional status, medical background, procedure details and hospital length of stay (LOS) was abstracted from the NSQIP database. We compared data on outcomes (LOS, postoperative complications, unplanned return visits to the emergency department and 30-day mortality) before and after ERAS. Results:We analyzed data for 609 patients (318 [52.2%] colon resection, 291 [47.8%] rectal resection; 190 [31.2%] before ERAS, 419 [68.8%] after ERAS). Significantly more patients were discharged within 5 days of surgery after ERAS than before (43.5% v. 29.1%, p < 0.05), and LOS more than 10 days was also reduced (23.7% v. 24.9%, p < 0.001). Implementation of ERAS was associated with an absolute reduction of 12% in postoperative complications and a significant reduction in surgical site infections among patients who underwent open procedures (p = 0.04). Conclusion:The introduction of an ERAS program for monitoring standardized perioperative care facilitates a data-driven approach to guide implementation of practice guidelines and establish the sustainability of ERAS protocols and data collection processes.Contexte : Il y a des obstacles au déploiement du programme de rétablissement postopératoire rapide ERAS (enhanced recovery after surgery), qui vise à réduire les taux de complications postopératoires et à abréger les séjours hospitaliers, parce que les soins périopératoires sont très diversifiés et que l'observance des équipes multidisciplinaires est cruciale à sa réussite. Les objectifs de ce projet étaient d'évaluer l'efficacité de la base de données NSQIP (National Surgical Quality Improvement Program) comme outil de contrôle continu des résultats du programme ERAS et pour évaluer ce dernier à titre de stratégie d'amélioration de la qualité des soins dans les hôpitaux.Méthodes : Les patients adultes qui ont subi une intervention colorectale non urgente à l'Hôpital d'Ottawa entre mars 2010 et septembre 2015 ont été inclus. Les données démographiques, le statut fonctionnel, les antécédents médicaux, les détails de l'intervention et la durée du séjour hospitalier (DSH) ont été extraits de la base de données NSQIP. Nous avons comparé la DSH, les complications post opératoires, les retours non planifiés aux urgences et la mortalité à 30 j avant et après le déploiement du programme ERAS.Résultats : N...
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