Toolkit: Enhancing Recovery Protocols for Colorectal Surgery
Action Plan
- Action Plan worksheets created specifically for the Enhanced Recovery Protocols for Colorectal Surgery initiative can be used to prioritize QI efforts and sent project goals.
To view the action plan, please login to your LMS account and navigate to this initiative’s library. If you do not have an account, you can create one here.
Recommended Readings
Guidelines developed as a collaborative effort between the American Society of Colon and Rectal Surgeons (ASCRS) and the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES).
- Created to define current best-quality care for enhanced recovery after colon and rectal surgery.
- Summarizes evidence supporting recommendations for specific components of protocol.
The Agency for Healthcare Research and Quality (AHRQ) in partnership with the American College of Surgeons and Johns Hopkins University developed a program to help hospitals across the country implement enhanced recovery protocols.
- The specific program they developed is based on this review paper, which is a comprehensive summary of the rationale and evidence supporting the individual surgical components of enhanced recovery protocols (anesthesia components are reported separately).
Evidence Review Conducted for the Agency for Healthcare Research and Quality Safety Program for Improving Surgical Care and Recovery: Focus on Anesthesiology for Colorectal Surgery. Ban KA, Gibbons MM, Ko CY, Wick EC, Cannesson M, Scott MJ, Grant MC, Wu CL. Anesth Analg. 2018 Apr 11
The Agency for Healthcare Research and Quality (AHRQ) in partnership with the American College of Surgeons and Johns Hopkins University developed a program to help hospitals across the country implement enhanced recovery protocols.
- The specific program they developed is based on this review paper, which is a comprehensive summary of the rationale and evidence supporting the individual Anesthesia components of enhanced recovery protocols (surgical components are reported separately)
- Brief summary of enhanced recovery protocols for colorectal surgery.
- Includes a link to the Society of American Gastrointestinal and Endoscopic Surgeons SMART Enhanced Recovery Program, which was developed to facilitate wider implementation of enhanced recovery protocols in colorectal surgery as well as other surgical procedures.
- The website includes evidence reviews, tips for project management, and examples of order sets and patient materials.
- https://sages.org/smart-enhanced-recovery-program/
- In 2014, Gunderson Health System implemented an enhanced recovery after surgery protocol. This article summarized the details of their protocol as well as the approach they used for development and implementation, highlighting the importance of multidisciplinary collaborative approach.
- In the first year of the program, length of stay was successfully reduced without a significant difference in morbidity or mortality.
Practice Guideline for Preoperative Fasting and the Use of Pharmacologic Agents to Reduce the Risk of Pulmonary Aspiration: Application to Healthy Patients Undergoing Elective Procedures”.
Includes specific recommendation from American Society of Anesthesiologists (ASA) to allow patients to drink clear liquids until up to 2 hours before receiving general anesthesia.
- Quality improvement program focused on Prehab available through American College of Surgeons website.
- Includes specific recommendations regarding diet management and prevention of nausea and ileus.
- Click here for graphic of I-FEED scoring system guiding advancement of diet postoperatively.
- Comprehensive approach to “optimal analgesia” covering prop through PACU.
- Comprehensive approach to “optimal analgesia” covering PACU to discharge.
- Includes summaries of multiple options for non-opioid pain management.