Implementing enhanced recovery after bariatric surgery protocol: a retrospective study.

Area of Science:

• Surgical Innovation
• Hospital Operations Management
• Patient Outcomes Research

Background:

• Increasing demand for bariatric surgery strains limited hospital capacity.
• The Enhanced Recovery After Bariatric Surgery (ERABS) protocol aims to optimize patient flow and outcomes.
• Limited data exists on ERABS' impact on operating room logistics and postoperative complications in academic settings.

Purpose of the Study:

• To compare operating room logistics and postoperative complications before and after implementing the ERABS protocol.
• To evaluate the effect of ERABS on length of hospital stay, a primary endpoint.
• To assess secondary endpoints including operating room turnover times, induction times, surgical times, and complication rates.

Main Methods:

• Retrospective study comparing two periods: pre-ERABS and ERABS.
• Analysis of data from 374 patients undergoing bariatric surgery (228 pre-ERABS, 146 ERABS).
• Key metrics: length of stay, turnover time, induction time, surgical time, procedure time, re-admissions, re-operations, and complications.

Main Results:

• Significant reduction in length of hospital stay from 3.7 to 2.1 days (P < 0.001).
• Shortened procedure times for gastric bypass and sleeve gastrectomy (P < 0.001).
• Reduced induction times (15.2 to 12.5 min, P < 0.001) and turnover times (38 to 11 min, P < 0.001).
• No significant change in re-operations, re-admissions, or complication rates.

Conclusions:

• The ERABS protocol effectively improves operating room efficiency and reduces hospital length of stay.
• ERABS implementation leads to significant time savings in bariatric surgery procedures and room turnover.
• The protocol enhances operational capacity without compromising patient safety or increasing adverse events.