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Implementing Change: Sustaining Enhanced Recovery After Surgery Protocols in Pediatric Surgery Using Iterative

Allison R Thompson1, Jack P Vernamonti2, Paris Rollins3

  • 1Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, Michigan.

The Journal of Surgical Research
|April 26, 2024
PubMed

Insights

Enhanced Recovery After Surgery (ERAS) protocols show high compliance (89%) in pediatric pectus repair, improving pain management and recovery times. Sustainability requires institutional adaptation and implementation science strategies.

Area of Science:

  • Pediatric Surgery
  • Surgical Protocols
  • Implementation Science

Background:

  • Enhanced Recovery After Surgery (ERAS) protocols are increasingly adopted in pediatric surgery.
  • Limited data exists on ERAS protocol compliance and sustainability in this population.

Purpose of the Study:

  • To prospectively evaluate the compliance and impact of an ERAS protocol for pediatric pectus repair.
  • To compare outcomes with a historical control group.

Main Methods:

  • Prospective observational study at a children's hospital.
  • Evaluated overall ERAS protocol compliance at 1 year postimplementation.
  • Compared outcomes to 2 years of historical pectus repair data.

Main Results:

  • Overall ERAS protocol compliance reached 89% at 12 months.
  • Significantly increased use of preoperative acetaminophen and gabapentin compared to controls.
  • Reduced time to normal diet postoperatively (0.53 days vs. 1.16 days).
  • No significant difference in readmission rates.

Conclusions:

  • ERAS protocol compliance is variable across different care phases.
  • Sustaining ERAS protocols requires institutional tailoring and patient population considerations.
  • Implementation science is crucial for identifying and addressing compliance gaps.
Abstract

Keywords:
Enhanced recovery after surgeryPectus repairPediatric surgeryProtocol compliance

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