Implementation of integrated recovery pathway quickly improves outcomes

Editor's Note

A trust-based accountability model that included senior hospital leadership and frontline providers provided an enabling structure to rapidly implement an integrated recovery pathway and quickly improve outcomes, value, and experience of colorectal surgical patients, in this study.

The pathway included preoperative education, mechanical bowel preparation with oral antibiotics, chlorhexidine bathing, multimodal analgesia with thoracic epidural or transversus abdominus plane blocks, restricted IV fluid protocol, early mobilization, and resumption of oral intake.

Of  310 patients who had surgery in the baseline period, mean length of stay (LOS) was 7 days, and the mean surgical site infection (SSI) rate was 18.8%. For the 330 patients who had surgery on the pathway, LOS was 5 days, and the SSI rate was 7.3%.