000131402 001__ 131402
000131402 005__ 20240208155436.0
000131402 0247_ $$2doi$$a10.1016/j.jclinane.2021.110378
000131402 0248_ $$2sideral$$a127938
000131402 037__ $$aART-2021-127938
000131402 041__ $$aeng
000131402 100__ $$aZorrilla-Vaca, Andres
000131402 245__ $$aInstitutional factors associated with adherence to enhanced recovery protocols for colorectal surgery: Secondary analysis of a multicenter study
000131402 260__ $$c2021
000131402 5203_ $$aIntroduction
Adherence to Enhanced Recovery Protocols (ERPs) is associated with faster functional recovery, better patient satisfaction, lower complication rates and reduced length of hospital stay. Understanding institutional barriers and facilitators is essential for improving adherence to ERPs. The purpose of this study was to identify institutional factors associated with adherence to an ERP for colorectal surgery.
Methods
A secondary analysis of a nationwide study was conducted including 686 patients who underwent colorectal surgery across twenty-one institutions in Spain. Adherence to ERPs was calculated based upon the components recommended by the Enhanced Recovery After Surgery (ERAS®) Society. Institutional characteristics (i.e., case volume, ERP duration, anesthesia staff size, multidisciplinary meetings, leadership discipline) were captured from each participating program. Multivariable regression was performed to determine characteristics associated with adherence.
Results
The median adherence to ERAS was 68.2% (IQR 59.1%–81.8%). Multivariable linear regression revealed that anesthesiologist leadership (+5.49%, 95%CI +2.81% to +8.18%, P < 0.01), duration of ERAS implementation (+0.46% per year, 95%CI +0.06% to +0.86%, P < 0.01) and the use of regular multidisciplinary meetings (+4.66%, 95%CI +0.06 to +7.74%, P < 0.01) were independently associated with greater adherence. Case volume (−2.38% per 4 cases weekly, 95%CI -3.03 to −1.74, P < 0.01) and number of anesthesia providers (−1.19% per 10 providers, 95%CI +2.23 to −8.18%, P < 0.01) were negatively associated with adherence.
Conclusion
Adherence to ERPs is strongly associated with anesthesiology leadership, regular multidisciplinary meetings, and program duration, whereas case volume and the size of the anesthesia staff were potential barriers. These findings highlight the importance of strong leadership, experience and establishing a multidisciplinary team when developing an ERP for colorectal surgery.
000131402 540__ $$9info:eu-repo/semantics/openAccess$$aAll rights reserved$$uhttp://www.europeana.eu/rights/rr-f/
000131402 590__ $$a9.375$$b2021
000131402 591__ $$aANESTHESIOLOGY$$b3 / 34 = 0.088$$c2021$$dQ1$$eT1
000131402 592__ $$a1.081$$b2021
000131402 593__ $$aAnesthesiology and Pain Medicine$$c2021$$dQ1
000131402 594__ $$a6.7$$b2021
000131402 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/publishedVersion
000131402 700__ $$aStone, Alexander B.
000131402 700__ $$aRipolles-Melchor, Javier
000131402 700__ $$aAbad-Motos, Ane
000131402 700__ $$0(orcid)0000-0001-7964-1166$$aRamirez-Rodriguez, Jose M.$$uUniversidad de Zaragoza
000131402 700__ $$aGalan-Menendez, Patricia
000131402 700__ $$aMena, Gabriel E.
000131402 700__ $$aGrant, Michael C.
000131402 700__ $$0(orcid)0000-0003-2462-1904$$aMartínez-Ubieto, Javier$$uUniversidad de Zaragoza
000131402 700__ $$aThe Spanish Perioperative Audit and Research Network (RedGERM) Power Investigators Group
000131402 7102_ $$11013$$2090$$aUniversidad de Zaragoza$$bDpto. Cirugía$$cÁrea Cirugía
000131402 773__ $$g74 (2021), 110378 [6 pp.]$$pJ. clin. anesth.$$tJOURNAL OF CLINICAL ANESTHESIA$$x0952-8180
000131402 8564_ $$s382997$$uhttps://zaguan.unizar.es/record/131402/files/texto_completo.pdf$$yVersión publicada
000131402 8564_ $$s2430089$$uhttps://zaguan.unizar.es/record/131402/files/texto_completo.jpg?subformat=icon$$xicon$$yVersión publicada
000131402 909CO $$ooai:zaguan.unizar.es:131402$$particulos$$pdriver
000131402 951__ $$a2024-02-08-14:39:10
000131402 980__ $$aARTICLE