Uptake of enhanced recovery practices by SAGES members: a survey

Deborah S. Keller, Conor P. Delaney, Anthony J. Senagore, Liane S. Feldman, Liane Feldman, Conor Delaney, Gina Adrales, Rajesh Aggarwal, Thomas Aloia, Diana Diesen, Justin Dimick, Courtney Doyle, Lorenzo Ferri, Julio Fiore, Gerald Fried, Pascal Fuchshuber, Alexis Grucela, Matthew Hutter, Edmundo Inga-Zapata, Rohan JosephDeborah Keller, Lawrence Lee, Anne Lidor, Sumeet Mittal, Charles Paget, Benjamin Poulose, Patrick Reardon, Michele Riordon, Anthony Senagore, Vadim Sherman, Julie Thacker, Tonia Young-Fadok, on Behalf of the SAGES SMART Task Force

    Research output: Contribution to journalArticle

    6 Citations (Scopus)

    Abstract

    Background: The SAGES Surgical Multimodal Accelerated Recovery Trajectory (SMART) Enhanced Recovery Task Force aims to increase awareness and provide tools for members to successfully implement enhanced recovery pathways (ERPs) to improve clinical outcomes and patient satisfaction. An initial step was to survey SAGES member on their knowledge, use, and impediments to enhanced recovery. Methods: An online survey designed by SMART committee members to define SAGES member’s awareness and use of enhanced recovery principles and practice was emailed to all SAGES members. Reminders were sent 2 and 3 weeks later, encouraging completion of the survey. The web-based survey included 48 questions and took an estimated 20 min to complete. Results: A total of 229 members completed the survey. Respondents were primarily general/MIS surgeons (82.6%) working in an urban location (85.5%), with a bell-shaped age distribution (median 35–44). Almost half regularly used some elements of ERPs (48.7%), but 30% were unfamiliar with the concept. Wide variety in the specific ERP elements used and discharge criteria were reported. The majority had to create and implement their own plan (70.4%). Roadblocks to implementation were inconsistencies with partners/covering physicians (56.3%), nursing education (46.6%), and resources (34.7%). When implemented, members saw improvements in length of stay (88%), patient satisfaction (54.7%), postoperative pain (53.3%), time to return of bowel function (52.7%), and readmissions (16.7%). A need for education and standardization was especially seen in preoperative care, with 74.4% fasting patients from midnight the night before surgery. Wide variations were also reported in pain management practices. An overwhelming majority (89%) reported that having a protocol endorsed by a national organization, such as SAGES, would help with implementation. Conclusions: From this survey of SAGES members, there is a need for education, tools, and standardized protocols to increase awareness, support implementation, and encourage wider utilization of ERP. The overwhelming majority stated having a protocol endorsed by a national organization, such as SAGES, would facilitate implementation.

    Original languageEnglish (US)
    Pages (from-to)1-8
    Number of pages8
    JournalSurgical Endoscopy and Other Interventional Techniques
    DOIs
    StateAccepted/In press - Dec 23 2016

    Fingerprint

    Patient Satisfaction
    Organizations
    Committee Membership
    Preoperative Care
    Education
    Nursing Education
    Age Distribution
    Advisory Committees
    Pain Management
    Postoperative Pain
    Surveys and Questionnaires
    Fasting
    Length of Stay
    Physicians
    Surgeons

    Keywords

    • Enhanced recovery after surgery
    • Enhanced recovery pathways
    • Minimally invasive surgery
    • Patient outcomes

    ASJC Scopus subject areas

    • Surgery

    Cite this

    Keller, D. S., Delaney, C. P., Senagore, A. J., Feldman, L. S., Feldman, L., Delaney, C., ... on Behalf of the SAGES SMART Task Force (Accepted/In press). Uptake of enhanced recovery practices by SAGES members: a survey. Surgical Endoscopy and Other Interventional Techniques, 1-8. https://doi.org/10.1007/s00464-016-5378-8

    Uptake of enhanced recovery practices by SAGES members : a survey. / Keller, Deborah S.; Delaney, Conor P.; Senagore, Anthony J.; Feldman, Liane S.; Feldman, Liane; Delaney, Conor; Adrales, Gina; Aggarwal, Rajesh; Aloia, Thomas; Diesen, Diana; Dimick, Justin; Doyle, Courtney; Ferri, Lorenzo; Fiore, Julio; Fried, Gerald; Fuchshuber, Pascal; Grucela, Alexis; Hutter, Matthew; Inga-Zapata, Edmundo; Joseph, Rohan; Keller, Deborah; Lee, Lawrence; Lidor, Anne; Mittal, Sumeet; Paget, Charles; Poulose, Benjamin; Reardon, Patrick; Riordon, Michele; Senagore, Anthony; Sherman, Vadim; Thacker, Julie; Young-Fadok, Tonia; on Behalf of the SAGES SMART Task Force.

    In: Surgical Endoscopy and Other Interventional Techniques, 23.12.2016, p. 1-8.

    Research output: Contribution to journalArticle

    Keller, DS, Delaney, CP, Senagore, AJ, Feldman, LS, Feldman, L, Delaney, C, Adrales, G, Aggarwal, R, Aloia, T, Diesen, D, Dimick, J, Doyle, C, Ferri, L, Fiore, J, Fried, G, Fuchshuber, P, Grucela, A, Hutter, M, Inga-Zapata, E, Joseph, R, Keller, D, Lee, L, Lidor, A, Mittal, S, Paget, C, Poulose, B, Reardon, P, Riordon, M, Senagore, A, Sherman, V, Thacker, J, Young-Fadok, T & on Behalf of the SAGES SMART Task Force 2016, 'Uptake of enhanced recovery practices by SAGES members: a survey', Surgical Endoscopy and Other Interventional Techniques, pp. 1-8. https://doi.org/10.1007/s00464-016-5378-8
    Keller, Deborah S. ; Delaney, Conor P. ; Senagore, Anthony J. ; Feldman, Liane S. ; Feldman, Liane ; Delaney, Conor ; Adrales, Gina ; Aggarwal, Rajesh ; Aloia, Thomas ; Diesen, Diana ; Dimick, Justin ; Doyle, Courtney ; Ferri, Lorenzo ; Fiore, Julio ; Fried, Gerald ; Fuchshuber, Pascal ; Grucela, Alexis ; Hutter, Matthew ; Inga-Zapata, Edmundo ; Joseph, Rohan ; Keller, Deborah ; Lee, Lawrence ; Lidor, Anne ; Mittal, Sumeet ; Paget, Charles ; Poulose, Benjamin ; Reardon, Patrick ; Riordon, Michele ; Senagore, Anthony ; Sherman, Vadim ; Thacker, Julie ; Young-Fadok, Tonia ; on Behalf of the SAGES SMART Task Force. / Uptake of enhanced recovery practices by SAGES members : a survey. In: Surgical Endoscopy and Other Interventional Techniques. 2016 ; pp. 1-8.
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    abstract = "Background: The SAGES Surgical Multimodal Accelerated Recovery Trajectory (SMART) Enhanced Recovery Task Force aims to increase awareness and provide tools for members to successfully implement enhanced recovery pathways (ERPs) to improve clinical outcomes and patient satisfaction. An initial step was to survey SAGES member on their knowledge, use, and impediments to enhanced recovery. Methods: An online survey designed by SMART committee members to define SAGES member’s awareness and use of enhanced recovery principles and practice was emailed to all SAGES members. Reminders were sent 2 and 3 weeks later, encouraging completion of the survey. The web-based survey included 48 questions and took an estimated 20 min to complete. Results: A total of 229 members completed the survey. Respondents were primarily general/MIS surgeons (82.6{\%}) working in an urban location (85.5{\%}), with a bell-shaped age distribution (median 35–44). Almost half regularly used some elements of ERPs (48.7{\%}), but 30{\%} were unfamiliar with the concept. Wide variety in the specific ERP elements used and discharge criteria were reported. The majority had to create and implement their own plan (70.4{\%}). Roadblocks to implementation were inconsistencies with partners/covering physicians (56.3{\%}), nursing education (46.6{\%}), and resources (34.7{\%}). When implemented, members saw improvements in length of stay (88{\%}), patient satisfaction (54.7{\%}), postoperative pain (53.3{\%}), time to return of bowel function (52.7{\%}), and readmissions (16.7{\%}). A need for education and standardization was especially seen in preoperative care, with 74.4{\%} fasting patients from midnight the night before surgery. Wide variations were also reported in pain management practices. An overwhelming majority (89{\%}) reported that having a protocol endorsed by a national organization, such as SAGES, would help with implementation. Conclusions: From this survey of SAGES members, there is a need for education, tools, and standardized protocols to increase awareness, support implementation, and encourage wider utilization of ERP. The overwhelming majority stated having a protocol endorsed by a national organization, such as SAGES, would facilitate implementation.",
    keywords = "Enhanced recovery after surgery, Enhanced recovery pathways, Minimally invasive surgery, Patient outcomes",
    author = "Keller, {Deborah S.} and Delaney, {Conor P.} and Senagore, {Anthony J.} and Feldman, {Liane S.} and Liane Feldman and Conor Delaney and Gina Adrales and Rajesh Aggarwal and Thomas Aloia and Diana Diesen and Justin Dimick and Courtney Doyle and Lorenzo Ferri and Julio Fiore and Gerald Fried and Pascal Fuchshuber and Alexis Grucela and Matthew Hutter and Edmundo Inga-Zapata and Rohan Joseph and Deborah Keller and Lawrence Lee and Anne Lidor and Sumeet Mittal and Charles Paget and Benjamin Poulose and Patrick Reardon and Michele Riordon and Anthony Senagore and Vadim Sherman and Julie Thacker and Tonia Young-Fadok and {on Behalf of the SAGES SMART Task Force}",
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    doi = "10.1007/s00464-016-5378-8",
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    T1 - Uptake of enhanced recovery practices by SAGES members

    T2 - a survey

    AU - Keller, Deborah S.

    AU - Delaney, Conor P.

    AU - Senagore, Anthony J.

    AU - Feldman, Liane S.

    AU - Feldman, Liane

    AU - Delaney, Conor

    AU - Adrales, Gina

    AU - Aggarwal, Rajesh

    AU - Aloia, Thomas

    AU - Diesen, Diana

    AU - Dimick, Justin

    AU - Doyle, Courtney

    AU - Ferri, Lorenzo

    AU - Fiore, Julio

    AU - Fried, Gerald

    AU - Fuchshuber, Pascal

    AU - Grucela, Alexis

    AU - Hutter, Matthew

    AU - Inga-Zapata, Edmundo

    AU - Joseph, Rohan

    AU - Keller, Deborah

    AU - Lee, Lawrence

    AU - Lidor, Anne

    AU - Mittal, Sumeet

    AU - Paget, Charles

    AU - Poulose, Benjamin

    AU - Reardon, Patrick

    AU - Riordon, Michele

    AU - Senagore, Anthony

    AU - Sherman, Vadim

    AU - Thacker, Julie

    AU - Young-Fadok, Tonia

    AU - on Behalf of the SAGES SMART Task Force

    PY - 2016/12/23

    Y1 - 2016/12/23

    N2 - Background: The SAGES Surgical Multimodal Accelerated Recovery Trajectory (SMART) Enhanced Recovery Task Force aims to increase awareness and provide tools for members to successfully implement enhanced recovery pathways (ERPs) to improve clinical outcomes and patient satisfaction. An initial step was to survey SAGES member on their knowledge, use, and impediments to enhanced recovery. Methods: An online survey designed by SMART committee members to define SAGES member’s awareness and use of enhanced recovery principles and practice was emailed to all SAGES members. Reminders were sent 2 and 3 weeks later, encouraging completion of the survey. The web-based survey included 48 questions and took an estimated 20 min to complete. Results: A total of 229 members completed the survey. Respondents were primarily general/MIS surgeons (82.6%) working in an urban location (85.5%), with a bell-shaped age distribution (median 35–44). Almost half regularly used some elements of ERPs (48.7%), but 30% were unfamiliar with the concept. Wide variety in the specific ERP elements used and discharge criteria were reported. The majority had to create and implement their own plan (70.4%). Roadblocks to implementation were inconsistencies with partners/covering physicians (56.3%), nursing education (46.6%), and resources (34.7%). When implemented, members saw improvements in length of stay (88%), patient satisfaction (54.7%), postoperative pain (53.3%), time to return of bowel function (52.7%), and readmissions (16.7%). A need for education and standardization was especially seen in preoperative care, with 74.4% fasting patients from midnight the night before surgery. Wide variations were also reported in pain management practices. An overwhelming majority (89%) reported that having a protocol endorsed by a national organization, such as SAGES, would help with implementation. Conclusions: From this survey of SAGES members, there is a need for education, tools, and standardized protocols to increase awareness, support implementation, and encourage wider utilization of ERP. The overwhelming majority stated having a protocol endorsed by a national organization, such as SAGES, would facilitate implementation.

    AB - Background: The SAGES Surgical Multimodal Accelerated Recovery Trajectory (SMART) Enhanced Recovery Task Force aims to increase awareness and provide tools for members to successfully implement enhanced recovery pathways (ERPs) to improve clinical outcomes and patient satisfaction. An initial step was to survey SAGES member on their knowledge, use, and impediments to enhanced recovery. Methods: An online survey designed by SMART committee members to define SAGES member’s awareness and use of enhanced recovery principles and practice was emailed to all SAGES members. Reminders were sent 2 and 3 weeks later, encouraging completion of the survey. The web-based survey included 48 questions and took an estimated 20 min to complete. Results: A total of 229 members completed the survey. Respondents were primarily general/MIS surgeons (82.6%) working in an urban location (85.5%), with a bell-shaped age distribution (median 35–44). Almost half regularly used some elements of ERPs (48.7%), but 30% were unfamiliar with the concept. Wide variety in the specific ERP elements used and discharge criteria were reported. The majority had to create and implement their own plan (70.4%). Roadblocks to implementation were inconsistencies with partners/covering physicians (56.3%), nursing education (46.6%), and resources (34.7%). When implemented, members saw improvements in length of stay (88%), patient satisfaction (54.7%), postoperative pain (53.3%), time to return of bowel function (52.7%), and readmissions (16.7%). A need for education and standardization was especially seen in preoperative care, with 74.4% fasting patients from midnight the night before surgery. Wide variations were also reported in pain management practices. An overwhelming majority (89%) reported that having a protocol endorsed by a national organization, such as SAGES, would help with implementation. Conclusions: From this survey of SAGES members, there is a need for education, tools, and standardized protocols to increase awareness, support implementation, and encourage wider utilization of ERP. The overwhelming majority stated having a protocol endorsed by a national organization, such as SAGES, would facilitate implementation.

    KW - Enhanced recovery after surgery

    KW - Enhanced recovery pathways

    KW - Minimally invasive surgery

    KW - Patient outcomes

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