Implementation of a fast-track perioperative care program: what are the difficulties?

Area of Science:

• Colorectal Surgery
• Surgical Recovery Protocols
• Health Services Research

Background:

• Evaluating the feasibility and impact of fast-track (FT) surgical programs.
• Assessing the effect of FT programs on postoperative recovery in colorectal surgery patients.

Purpose of the Study:

• To determine the feasibility of implementing a fast-track program for elective colorectal resections.
• To evaluate the impact of a fast-track program on postoperative recovery outcomes.

Main Methods:

• Prospective data collection for the FT group and retrospective data for the traditional care (TC) group.
• Comparison of outcome parameters including FT modality application, patient satisfaction, morbidity, re-operation, hospital stay, and readmission rates.
• Analysis of 107 patients undergoing elective segmental colorectal resection (55 FT vs. 52 TC).

Main Results:

• An average of 7.4 out of 13 FT modalities were successfully applied per patient.
• Median primary hospital stay (PHS) was 4.0 days (FT) vs. 6.0 days (TC) (p < 0.01).
• Median total hospital stay (THS) was 4.0 days (FT) vs. 6.5 days (TC) (p < 0.03), with comparable patient satisfaction and morbidity.

Conclusions:

• Fast-track program implementation faced challenges with a low realization rate of predefined modalities.
• Despite incomplete implementation, the FT program significantly reduced primary and total hospital stay.
• The fast-track approach demonstrated feasibility in improving postoperative recovery without compromising patient satisfaction.