Evidence map›Paper›PMID 32437096›Full record

ArticleCanadian journal of surgery. Journal canadien de chirurgie2020

Sustainability of an Enhanced Recovery After Surgery initiative for elective colorectal resections in a community hospital.

Alexander Norman, Krista Mahoney, Erin Ballah, Jeremy Pridham, Chris Smith, Patrick Parfrey

Erratum issuedOpen access · diamondAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Canadian journal of surgery. Journal canadien de chirurgie, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
1.2field-weighted citation impact, top 21% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 13 citations in OpenAlex.

  1. Trial
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

6 authors at 2 institutions in 1 country.

Alexander NormanFrom the Clinical Epidemiology Unit, Memorial University of Newfoundland, St. John's, Nfld. (Norman, Mahoney, Parfrey); Eastern Health, St. John's, Nfld. (Ballah); the Discipline of Anesthesia, Memorial University of Newfoundland, St. John's, Nfld. (Pridham); and the Discipline of Surgery, Memorial University of Newfoundland, St. John's, Nfld. (Smith).
Krista MahoneyFrom the Clinical Epidemiology Unit, Memorial University of Newfoundland, St. John's, Nfld. (Norman, Mahoney, Parfrey); Eastern Health, St. John's, Nfld. (Ballah); the Discipline of Anesthesia, Memorial University of Newfoundland, St. John's, Nfld. (Pridham); and the Discipline of Surgery, Memorial University of Newfoundland, St. John's, Nfld. (Smith).
Erin BallahFrom the Clinical Epidemiology Unit, Memorial University of Newfoundland, St. John's, Nfld. (Norman, Mahoney, Parfrey); Eastern Health, St. John's, Nfld. (Ballah); the Discipline of Anesthesia, Memorial University of Newfoundland, St. John's, Nfld. (Pridham); and the Discipline of Surgery, Memorial University of Newfoundland, St. John's, Nfld. (Smith).
Jeremy PridhamFrom the Clinical Epidemiology Unit, Memorial University of Newfoundland, St. John's, Nfld. (Norman, Mahoney, Parfrey); Eastern Health, St. John's, Nfld. (Ballah); the Discipline of Anesthesia, Memorial University of Newfoundland, St. John's, Nfld. (Pridham); and the Discipline of Surgery, Memorial University of Newfoundland, St. John's, Nfld. (Smith).
Chris SmithFrom the Clinical Epidemiology Unit, Memorial University of Newfoundland, St. John's, Nfld. (Norman, Mahoney, Parfrey); Eastern Health, St. John's, Nfld. (Ballah); the Discipline of Anesthesia, Memorial University of Newfoundland, St. John's, Nfld. (Pridham); and the Discipline of Surgery, Memorial University of Newfoundland, St. John's, Nfld. (Smith).
Patrick ParfreyFrom the Clinical Epidemiology Unit, Memorial University of Newfoundland, St. John's, Nfld. (Norman, Mahoney, Parfrey); Eastern Health, St. John's, Nfld. (Ballah); the Discipline of Anesthesia, Memorial University of Newfoundland, St. John's, Nfld. (Pridham); and the Discipline of Surgery, Memorial University of Newfoundland, St. John's, Nfld. (Smith).
Memorial University of Newfoundland · CASt. John’s Health Sciences Centre · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: In March 2016, an Enhanced Recovery After Surgery (ERAS) initiative was implemented for all elective colorectal resections at an urban hospital in St. John's, Newfoundland and Labrador, Canada. An ERAS coordinator supervised and enforced guideline compliance for 6 months. The aim of this study was to evaluate the sustainability of the ERAS program after supervision of guideline compliance was eliminated. Methods: Patient outcomes and guideline compliance were compared between surgeries performed under standard practice (April 2014 to March 2015) and those performed during and after the implementation of the ERAS initiative (March 2016 to August 2016 was the implementation phase and September 2016 to February 2017 was the sustainability phase). Results: Hospital length of stay decreased from 7.26 days at baseline to 5.44 days during the implementation phase of the ERAS program (p < 0.001). There was no significant difference between length of stay at baseline and during the 6-month sustainability phase of the ERAS program (7.10 d). There were no significant differences in rates of readmission or mortality during and after implementation. Rate of ileus decreased significantly from 13.8% during the implementation phase to 4.6% during the sustainability phase (p = 0.036). Total guideline compliance increased from 52.2% at baseline to 80.7% during the implementation phase (p < 0.001), and decreased to 74.7% during the sustainability phase (p < 0.001). Adherence to postoperative guidelines regressed: 79.2% in the implementation phase and 68.6% in the sustainability phase (p < 0.001). Conclusion: La durée des séjours à l’hôpital a diminué après l’adoption du programme de RAAC, lorsque le coordonnateur du programme était présent. Les méthodes de maintien des lignes directrices après leur adoption seront cruciales au succès de programmes similaires à l’avenir.

Indexed as

Guideline AdherenceAgedCanadaClinical ProtocolsColectomyColorectal NeoplasmsElective Surgical ProceduresEnhanced Recovery After SurgeryFemaleFollow-Up StudiesHospitals, CommunityHumansIncidenceLength of StayMaleMiddle Aged

Identifiers

PMID32437096
PMCPMC7486128
OpenAlexW3026811985

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.