Improving Outcomes in Colorectal Surgery by Sequential Implementation of Multiple Standardized Care Programs

摘要: Background The purpose of this study was to examine the impact sequential implementation enhanced recovery program (ERP) and surgical site infection bundle (SSIB) on short-term outcomes in colorectal surgery (CRS) determine if presence multiple standardized care programs provides additive benefit. Study Design Institutional ACS-NSQIP data were used identify patients who underwent elective CRS from September 2006 March 2013. cohort stratified into 3 groups relative ERP (February 1, 2010) SSIB (July 2011). Unadjusted characteristics 30-day assessed, inverse proportional weighting then adjusted effect these programs. Results There 787 included: 337, 165, 285 pre-ERP/SSIB, post-ERP/pre-SSIB, post-ERP/SSIB periods, respectively. After probability (IPW) adjustment, balanced with respect patient procedural considered. Compared pre-ERP/SSIB group, post-ERP/pre-SSIB group had significantly reduced length hospitalization (8.3 vs 6.6 days, p = 0.01) but did not differ postoperative wound complications sepsis. Subsequent introduction resulted a significant decrease superficial SSI (16.1% 6.3%, p Conclusions Sequential provided incremental improvements while controlling hospital costs, supporting their combined use as an effective strategy toward improving quality care.