Enhanced recoveryprogramme for colorectal surgery: four year experience: P112

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Aim:The enhanced recoveryprogramme was introduced to improve post operative patient outcomes. It has been successfully adopted in several institutions with good results.Method:All consecutive patients undergoing elective colorectal resections and large hernia repairs within a 3-year period (2006-2008) were included (n = 169) in the study. A standard enhanced recoveryprotocol was followed. In 2008 a specialist enhanced recovery nurse was appointed to oversee theprogramme and participant education was vigorously instigated. A hospital booklet wasproduced for the duration of treatment clearly stipulating daily goals. Outcomes were re-audited in a second cohort of 179 patients over an 18 month period (2008-2009).Results:Mean length of stay was reduced from 8 to 6.5 days, mortality from 2.11% to 0.72% and short-term morbidity from 1.88% to 1.55% (P < 0.05 for all variables). Significantly, mean length of stay decreased further to 5.6 days after the specialist enhanced recovery nurse was appointed. Protocol parameters were achieved in more than 90% of cases and no adverse effects associated with theprogramme were observed.Conclusions:Implementation of enhanced recoveryprogrammes using a multidisciplinary approach can lead to significant improvement in patient outcomes. Based on this experience, further expansion of theprogramme to include other complexprocedures may be advantageous.

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