Related Experiment Video
Updated: Jan 24, 2026
08:27
Muscle Velocity Recovery Cycles to Examine Muscle Membrane Properties
Published on: February 19, 2020
14.8K
Multicenter Observational Study Examining the Implementation of Enhanced Recovery Within the Virginia Surgical
Traci L Hedrick1, Robert H Thiele2, Taryn E Hassinger1
1Department of Surgery, University of Virginia Health System, Charlottesville, VA.
Journal of the American College of Surgeons
|May 21, 2019
Summary
Enhanced recovery (ER) protocols significantly reduced length of stay (LOS) and complications for patients undergoing elective laparoscopic colectomy. This collaborative quality improvement initiative demonstrated improved surgical outcomes through standardized care.
Area of Science:
- Surgical Quality Improvement
- Enhanced Recovery Protocols
- Multicenter Collaboration
Background:
- The American College of Surgeons (ACS) NSQIP Virginia Surgical Quality Collaborative (VSQC) aims to improve surgical outcomes via multi-institutional collaboration.
- Enhanced recovery (ER) protocols are known to reduce morbidity and length of stay (LOS) after elective surgery.
- The study hypothesized that ER implementation through VSQC would decrease postoperative complications and LOS in elective colectomy patients.
Purpose of the Study:
- To evaluate the impact of standardized, evidence-based enhanced recovery (ER) protocols on surgical outcomes.
- To assess whether multi-institutional collaboration through VSQC improves outcomes in elective colectomy.
Main Methods:
- Incremental implementation of ER protocols for elective colectomy patients across VSQC institutions starting in 2013.
- Data from 2,438 colectomies (1,035 pre-ER, 1,403 post-ER) from January 2012 to December 2016 in 4 hospitals.
- Analysis included before-and-after implementation comparison and multivariable logistic regression using risk-adjusted ACS NSQIP data.
Main Results:
- Median LOS decreased from 5 to 4 days for open colectomy patients post-ER implementation (p < 0.001).
- Laparoscopic colectomy patients showed reduced LOS (4 vs 3 days; p < 0.001), 30-day readmissions (12% vs 8%; p = 0.01), and complications (16% vs 9%; p < 0.001) post-ER.
- Multivariable analysis identified ER and laparoscopy as independent factors associated with reduced complication risk.
Conclusions:
- Implementation of enhanced recovery (ER) protocols within the VSQC framework was associated with reduced LOS.
- ER implementation led to decreased complications specifically in patients undergoing elective laparoscopic colectomy.
- Standardized care based on evidence-based practices across multiple institutions improved surgical outcomes.
Related Concept Videos
01:11Observational Studies
10.8K
Observational studies are a type of analytical study where researchers observe events without any interventions. In other words, the researcher does not influence the response variable or the experiment's outcome.
There are three types of observational studies – Prospective, retrospective, and cross-sectional.
Prospective Study
Prospective studies, also known as longitudinal or cohort studies, are carried out by collecting future data from groups sharing similar characteristics. One...
There are three types of observational studies – Prospective, retrospective, and cross-sectional.
Prospective Study
Prospective studies, also known as longitudinal or cohort studies, are carried out by collecting future data from groups sharing similar characteristics. One...
10.8K
01:24Nursing Process for Patient and Caregiver Teaching II: Planning and Implementation
2.0K
Planning for learning involves the development of a teaching plan. Teaching plans are similar to nursing care plans—both follow the steps of the nursing process. Planning in the teaching process involves setting goals and outcomes. Here, goals identify what a patient needs to achieve to understand a healthcare topic better, whereas the outcomes are the action to be performed by the patient to achieve the goal within a timeframe. For example, if the goal is to educate the patient about...
2.0K
01:29Chronic Pancreatitis II: Collaborative Care
335
The management of chronic pancreatitis is multifaceted, involving a comprehensive approach that includes thorough assessment, diagnostic testing, and a variety of management strategies.
Assessment:
Assessment:
335
02:30Naturalistic Observations
17.0K
If you want to understand how behavior occurs, one of the best ways to gain information is to simply observe the behavior in its natural context. However, people might change their behavior in unexpected ways if they know they are being observed. How do researchers obtain accurate information when people tend to hide their natural behavior? As an example, imagine that your professor asks everyone in your class to raise their hand if they always wash their hands after using the restroom. Chances...
17.0K
01:15Nursing Implementation
6.0K
Implementation is the execution of the nursing care plan developed during the planning phase.
The five steps to implementing effective nursing care include reassessing the patient, reviewing and revising the existing nursing care plan, organizing the resources and care delivery, anticipating and preventing complications, and implementing nursing interventions.
The five steps to implementing effective nursing care include reassessing the patient, reviewing and revising the existing nursing care plan, organizing the resources and care delivery, anticipating and preventing complications, and implementing nursing interventions.
6.0K
01:19Quality of Water
514
In concrete preparation, the quality of water is paramount as it affects the strength and durability of the concrete. Potable water is usually preferred; however, it must not have excessive sodium or potassium to prevent compromising the concrete's integrity. Water quality is typically evaluated based on impurities such as dissolved solids, chlorides, and sulfates, and its pH value is ideally between 6 and 8. Even slightly acidic natural water may be acceptable unless it contains harmful...
514