New Approach Reduces Length of Stay, Costs in Colorectal Surgery

A new approach to caring for patients undergoing colorectal surgery has shown faster recovery times, fewer complications, improved patient satisfaction, and reduced medical costs, according to a team of researchers at the University of Virginia Health System (UVA-Health).

The study, published online in the Journal of the American College of Surgeons, compared 98 consecutive historical controls with 109 consecutive patients who underwent surgery within the enhanced recovery protocol.

Currently, colorectal surgery patients stay in the hospital for 5-10 days, but the new, standardized approach from UVA-Health enables patients to become engaged in their care with provided educational materials, checklists, and counseling prior to the operation. Furthermore, the approach uses local anesthesia modalities instead of opioids during and after operation. Finally, patients are encouraged to eat and get out of bed as soon as possible after the operation.

“The key to our success is that we brought everyone who cares for these patients together, including anesthesiologists, nursing staff, pharmacists, nutritionists, and we coordinated every detail of their care,” study co-author Traci Hedrick, MD, FACS, assistant professor of surgery, said in a statement. “This recovery plan was a quality initiative right from the start.”

The enhanced recovery approach decreased the length of hospital stay by 2.2 days and overall complication rate by 17%. Patient satisfaction with pain control increased 55%.

Finally, the new approach reduced overall medical costs by as much as $7129 per patient, which tallied up to a total cost savings of approximately $777,061 in the enhanced recovery group.

One limitation of the study was the before and after design as there is always the possibility patients in the study are not similar. However, Dr Hedrick remains optimistic that this protocol for colorectal surgical care will be the standard in 5 years because it provides higher quality care at lower cost.

“We are now working to implement a similar protocol for other surgical specialties, as well as looking for additional ways to further improve our outcomes and patient experience,” she said. “This study shows just how successful small investments can be at raising the quality of care for patients.”