000165588 001__ 165588
000165588 005__ 20260113221445.0
000165588 0248_ $$2sideral$$a147290
000165588 037__ $$aART-2021-147290
000165588 041__ $$aeng
000165588 100__ $$aZorrilla Vaca, A.
000165588 245__ $$aInstitutional factors associated with adherence to enhanced recovery protocols for colorectal surgery: Secondary analysis of a multicenter study.
000165588 260__ $$c2021
000165588 5060_ $$aAccess copy available to the general public$$fUnrestricted
000165588 5203_ $$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.
000165588 540__ $$9info:eu-repo/semantics/openAccess$$aAll rights reserved$$uhttp://www.europeana.eu/rights/rr-f/
000165588 590__ $$a9.375$$b2021
000165588 591__ $$aANESTHESIOLOGY$$b3 / 34 = 0.088$$c2021$$dQ1$$eT1
000165588 592__ $$a1.081$$b2021
000165588 593__ $$aAnesthesiology and Pain Medicine$$c2021$$dQ1
000165588 594__ $$a6.7$$b2021
000165588 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/publishedVersion
000165588 700__ $$aStone, Alexander B.
000165588 700__ $$aRipolles Melchor, Javier
000165588 700__ $$aAbad Motos, Ane
000165588 700__ $$0(orcid)0000-0001-7964-1166$$aRamírez Rodriguez, José Manuel$$uUniversidad de Zaragoza
000165588 700__ $$aGalán Menendez, Patricia
000165588 700__ $$aMena, Gabriel E.
000165588 700__ $$aGrant, Michael C.
000165588 700__ $$aPower Investigators Group, (including all Researchers participating in POWER
000165588 7102_ $$11013$$2090$$aUniversidad de Zaragoza$$bDpto. Cirugía$$cÁrea Cirugía
000165588 773__ $$g16, 74 (2021), [6 pp.]$$pJ. clin. anesth.$$tJournal of clinical anesthesia$$x0952-8180
000165588 8564_ $$s476814$$uhttps://zaguan.unizar.es/record/165588/files/texto_completo.pdf$$yVersión publicada
000165588 8564_ $$s2430089$$uhttps://zaguan.unizar.es/record/165588/files/texto_completo.jpg?subformat=icon$$xicon$$yVersión publicada
000165588 909CO $$ooai:zaguan.unizar.es:165588$$particulos$$pdriver
000165588 951__ $$a2026-01-13-22:10:45
000165588 980__ $$aARTICLE