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Reducing hospital stay for colorectal surgery in ERAS setting by means of perioperative patient education of expected day of discharge

PURPOSE: Despite the enhanced recovery after surgery (ERAS) protocol, length of stay (LOS) after colorectal surgery varies considerably. The majority of longer admissions is often not medically necessary. We aimed to investigate possible reduction of LOS by perioperative education with an expected d...

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Autores principales: Tweed, Thaís T. T., Woortman, Carmen, Tummers, Stan, Bakens, Maikel J. A. M., van Bastelaar, James, Stoot, Jan H. M. B.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8195902/
https://www.ncbi.nlm.nih.gov/pubmed/33977333
http://dx.doi.org/10.1007/s00384-021-03948-0
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author Tweed, Thaís T. T.
Woortman, Carmen
Tummers, Stan
Bakens, Maikel J. A. M.
van Bastelaar, James
Stoot, Jan H. M. B.
author_facet Tweed, Thaís T. T.
Woortman, Carmen
Tummers, Stan
Bakens, Maikel J. A. M.
van Bastelaar, James
Stoot, Jan H. M. B.
author_sort Tweed, Thaís T. T.
collection PubMed
description PURPOSE: Despite the enhanced recovery after surgery (ERAS) protocol, length of stay (LOS) after colorectal surgery varies considerably. The majority of longer admissions is often not medically necessary. We aimed to investigate possible reduction of LOS by perioperative education with an expected discharge date (EDD). METHODS: This single-centre retrospective study included 578 patients who underwent surgery for colorectal cancer in 2016 with standard care (ERAS) and in 2018 with the addition of EDD education program (ERAS+). A comparison was made of a 1-year period prior to and following the implementation of EDD. The EDD was discussed at the outpatient clinic, preoperatively and during admission (with both the patient and family members daily). Standard EDD varied between 3 and 5 days depending on the resection type. Primary outcome was LOS; secondary outcomes were readmission, serious complications and 90-day mortality. RESULTS: Patients in ERAS+ (n = 242) had a shorter median LOS (4.0 vs. 5.0, p < 0.001) compared to patients in the regular ERAS group (n = 336). Fewer patients of ERAS+ experienced postoperative complications (71 (29.3%) vs. 198 (58.9%), p < 0.001). No difference was found in the number of readmissions (23 (9.5%) vs. 34 (10.1%), p = 0.807), reinterventions (25 (10.3%) vs. 30 (8.9%), p = 0.571) or mortality (5 (2.1%) vs. 9 (2.7%), p = 0.261) between the two groups. CONCLUSION: It is possible to reduce LOS within the ERAS program, by better perioperative education and expectation management of patients with use of an EDD. This program ensures better understanding, faster discharge and lower costs for the hospital without added risk of readmissions or complications.
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spelling pubmed-81959022021-06-28 Reducing hospital stay for colorectal surgery in ERAS setting by means of perioperative patient education of expected day of discharge Tweed, Thaís T. T. Woortman, Carmen Tummers, Stan Bakens, Maikel J. A. M. van Bastelaar, James Stoot, Jan H. M. B. Int J Colorectal Dis Original Article PURPOSE: Despite the enhanced recovery after surgery (ERAS) protocol, length of stay (LOS) after colorectal surgery varies considerably. The majority of longer admissions is often not medically necessary. We aimed to investigate possible reduction of LOS by perioperative education with an expected discharge date (EDD). METHODS: This single-centre retrospective study included 578 patients who underwent surgery for colorectal cancer in 2016 with standard care (ERAS) and in 2018 with the addition of EDD education program (ERAS+). A comparison was made of a 1-year period prior to and following the implementation of EDD. The EDD was discussed at the outpatient clinic, preoperatively and during admission (with both the patient and family members daily). Standard EDD varied between 3 and 5 days depending on the resection type. Primary outcome was LOS; secondary outcomes were readmission, serious complications and 90-day mortality. RESULTS: Patients in ERAS+ (n = 242) had a shorter median LOS (4.0 vs. 5.0, p < 0.001) compared to patients in the regular ERAS group (n = 336). Fewer patients of ERAS+ experienced postoperative complications (71 (29.3%) vs. 198 (58.9%), p < 0.001). No difference was found in the number of readmissions (23 (9.5%) vs. 34 (10.1%), p = 0.807), reinterventions (25 (10.3%) vs. 30 (8.9%), p = 0.571) or mortality (5 (2.1%) vs. 9 (2.7%), p = 0.261) between the two groups. CONCLUSION: It is possible to reduce LOS within the ERAS program, by better perioperative education and expectation management of patients with use of an EDD. This program ensures better understanding, faster discharge and lower costs for the hospital without added risk of readmissions or complications. Springer Berlin Heidelberg 2021-05-11 2021 /pmc/articles/PMC8195902/ /pubmed/33977333 http://dx.doi.org/10.1007/s00384-021-03948-0 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Original Article
Tweed, Thaís T. T.
Woortman, Carmen
Tummers, Stan
Bakens, Maikel J. A. M.
van Bastelaar, James
Stoot, Jan H. M. B.
Reducing hospital stay for colorectal surgery in ERAS setting by means of perioperative patient education of expected day of discharge
title Reducing hospital stay for colorectal surgery in ERAS setting by means of perioperative patient education of expected day of discharge
title_full Reducing hospital stay for colorectal surgery in ERAS setting by means of perioperative patient education of expected day of discharge
title_fullStr Reducing hospital stay for colorectal surgery in ERAS setting by means of perioperative patient education of expected day of discharge
title_full_unstemmed Reducing hospital stay for colorectal surgery in ERAS setting by means of perioperative patient education of expected day of discharge
title_short Reducing hospital stay for colorectal surgery in ERAS setting by means of perioperative patient education of expected day of discharge
title_sort reducing hospital stay for colorectal surgery in eras setting by means of perioperative patient education of expected day of discharge
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8195902/
https://www.ncbi.nlm.nih.gov/pubmed/33977333
http://dx.doi.org/10.1007/s00384-021-03948-0
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