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Summary

Implementing a bariatric enhanced recovery protocol (BERP) significantly reduced hospital length of stay and Schedule II medication prescriptions in community hospitals. Patient safety outcomes remained unaffected, demonstrating the protocol

Keywords:
Bariatric surgeryEnhanced recovery protocolLength of stayOpiate use reduction

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Area of Science:

  • Surgical Patient Care
  • Enhanced Recovery Pathways
  • Bariatric Surgery Outcomes

Background:

  • Bariatric enhanced recovery protocols (BERP) show potential to decrease length of stay (LOS) and hospital costs.
  • Further data is needed to compare patient outcomes before and after implementing enhanced recovery pathways.
  • This study introduces a BERP at a community hospital to reduce LOS and Schedule II substance use without compromising safety.

Purpose of the Study:

  • To evaluate the impact of a bariatric enhanced recovery protocol (BERP) on hospital length of stay (LOS).
  • To assess the effect of BERP on the prescription of Schedule II medications post-bariatric surgery.
  • To ensure patient safety is maintained throughout the enhanced recovery process.

Main Methods:

  • A combined retrospective and prospective analysis of 200 patients undergoing bariatric surgery.
  • Data collected from September 2016 to April 2018.
  • Statistical comparison using Mann-Whitney U, Pearson chi-square, and Fisher's exact tests.

Main Results:

  • Mean hospital LOS decreased from 2.3 days pre-protocol to 1.4 days with BERP (p < 0.001).
  • Sixty-five percent of BERP patients were discharged on hospital day 1, compared to 0% pre-protocol.
  • Schedule II medication prescriptions dropped from 100% pre-protocol to 9% with BERP (p < 0.001), with no significant difference in complication rates.

Conclusions:

  • Community hospitals can effectively reduce LOS and narcotic prescribing through enhanced recovery protocols.
  • BERP implementation leads to significant reductions in Schedule II medication use.
  • Safety-related outcomes are not compromised by adopting multimodal enhanced recovery approaches in bariatric surgery.