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 Joseph & 13 others Deborah 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

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.

LanguageEnglish (US)
Pages1-8
Number of pages8
JournalSurgical Endoscopy and Other Interventional Techniques
DOIs
StateAccepted/In press - Dec 23 2016
Externally publishedYes

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. DOI: 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. DOI: 10.1007/s00464-016-5378-8
Keller DS, Delaney CP, Senagore AJ, Feldman LS, Feldman L, Delaney C et al. Uptake of enhanced recovery practices by SAGES members: a survey. Surgical Endoscopy and Other Interventional Techniques. 2016 Dec 23;1-8. Available from, DOI: 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.",
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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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T1 - Uptake of enhanced recovery practices by SAGES members

T2 - Surgical Endoscopy

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

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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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