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New Program Aims to Optimize Colorectal Surgery

Participating facilities have access to tools and advice for implementing an evidenced-based clinical pathway.

Published: August 11, 2017

COMPREHENSIVE VIEW Colorectal surgery is the first of 5 cohorts included in the program, with clinical pathways for other specialties to follow.

Surgical facilities eager to enhance the outcomes and reduce the risks of colorectal surgery now have a 12-step, evidence-based clinical pathway to follow, according to a new report in the Journal of the American College of Surgeons.

Facilities participating in the Safety Program for Improving Surgical Care and Recovery (ISCR) may follow a standardized care plan — also known as an enhanced recovery pathway (ERP) — aimed at optimizing surgical care for patients, from pre-op to post-op. Some of the 12 primary components detailed in the colorectal ERP include everything from patient education and bowel preparation to early IV fluid discontinuation and the early removal of urinary catheters, according to the report.

To develop the pathway, researchers reviewed relevant research — original studies, systematic review articles and organizational guidelines, as well as expert opinions — published before December 2016. The review was conducted through a partnership between the Agency for Healthcare Research and Quality, the American College of Surgeons and the Johns Hopkins Medicine Armstrong Institute for Patient Safety and Quality in Baltimore, Md.

This national effort aims to disseminate best practices in perioperative care to more than 750 U.S. healthcare facilities across multiple surgical disciplines over the next 5 years. Surgical facilities participating in the program receive education, tools and coaching support as they roll out the same clinical pathway, as well as access to a registry for benchmarking and compliance tracking.

Elizabeth C. Wick, MD, FACS, an associate professor of surgery at the University of California San Francisco and a faculty member at the Johns Hopkins Medicine Armstrong Institute for Patient Safety and Quality, says the program has "dramatically helped improve" her patients' outcomes and experiences. "It also strengthened trans-disciplinary collaborations with my colleagues in nursing and anesthesia, as well as hospital leadership," says Dr. Wick, one of the report's co-authors.

The ISCR's colorectal surgery cohort, which was launched on July 1, has already enrolled several healthcare facilities and will continue to do so in the months ahead. Colorectal surgery represents the first of 5 ISCR cohorts, with orthopedic surgery, gynecologic surgery, emergency general surgery and bariatric surgery to follow.

Click here to request more information about the ISCR or to enroll in the program.

Bill Donahue

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