Category Ranking
98%
Total Visits
921
Avg Visit Duration
2 minutes
Citations
20
Article Abstract
Background: Randomised trials have shown an Enhanced Recovery Program (ERP) can shorten stay after colorectal surgery. Previous research has focused on patient compliance neglecting the role of care providers. National data on implementation and adherence to standardised care are lacking. We examined care organisation and delivery including the ERP, and correlated this with clinical outcomes.
Methods: A cross-sectional questionnaire was administered to surgeons and nurses in August-October 2015. All English National Health Service Trusts providing elective colorectal surgery were invited. Responses frequencies and variation were examined. Exploratory factor analysis was performed to identify underlying features of care. Standardised factor scores were correlated with elective clinical outcomes of length of stay, mortality and readmission rates from 2013-15.
Results: 218/600 (36.3%) postal responses were received from 84/90 (93.3%) Trusts that agreed to participate. Combined with email responses, 301 surveys were analysed. 281/301 (93.4%) agreed or strongly agreed that they had a standardised, ERP-based care protocol. However, 182/301 (60.5%) indicated all consultants managed post-operative oral intake similarly. After factor analysis, higher hospital average ERP-based care standardisation and clinician adherence score were significantly correlated with reduced length of stay, as well as higher ratings of teamwork and support for complication management.
Conclusions: Standardised, ERP-based care was near universal, but clinician adherence varied markedly. Units reporting higher levels of clinician adherence achieved the lowest length of stay. Having a protocol is not enough. Careful implementation and adherence by all of the team is vital to achieve the best results.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7773614 | PMC |
| http://dx.doi.org/10.1007/s00268-020-05810-w | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Implementing relational continuity in general practice-understanding who needs it, when, to what extent, how and why: a realist review protocol.
BMJ Open
September 2025
Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, England, UK.
Introduction: Relational continuity of care (RCC) refers to the sustained therapeutic relationship between a patient and a clinician, which fosters trust, enhances communication and facilitates the accumulation of knowledge about the patient. RCC is associated with enhanced patient outcomes, reduced hospital admissions, lower mortality rates, decreased healthcare costs and improved patient experience. Despite these benefits, reorganisations within the NHS and workforce challenges have led to an increased reliance on multidisciplinary and part-time working, resulting in fragmented care and a decline in RCC.
View Article and Find Full Text PDFGuideline adherence in surgical decisions for T1 colorectal cancer after endoscopic resection: large language models vs clinicians.
Int J Surg
September 2025
Digestive Endoscopy Center, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China.
Background: Patients with T1 colorectal cancer (CRC) often show poor adherence to guideline-recommended treatment strategies after endoscopic resection. To address this challenge and improve clinical decision-making, this study aims to compare the accuracy of surgical management recommendations between large language models (LLMs) and clinicians.
Methods: This retrospective study enrolled 202 patients with T1 CRC who underwent endoscopic resection at three hospitals.
Appetite measures as correlates of clinical response in mood disorders treated with ketamine: systematic review.
Front Nutr
August 2025
Faculty of Medicine, Department of Psychiatry, Medical University of Gdańsk, Gdańsk, Poland.
Unlabelled: Mood disorders, including major depressive disorder (MDD) and bipolar disorder (BP), significantly impact global health, with MDD affecting over 300 million people and BP affecting approximately 2% of the world's population. Ketamine, originally an anesthetic, has emerged as a promising treatment for patients with treatment-resistant depression (TRD), due to its unique pharmacological properties, such as N-methyl-D-aspartate (NMDA) receptor antagonism and anti-inflammatory effects. The potential of ketamine in treating depression has sparked debate regarding its effects on appetite.
View Article and Find Full Text PDFImproving Communication and Management Following a Positive Home HPV Self-Sampling Result: Comparing Intervention Strategies Between the HOME and STEP Trials.
Womens Health Rep (New Rochelle)
August 2025
Department of Epidemiology, University of Washington School of Public Health, Seattle, Washington, USA.
Background: Mailed human papillomavirus (HPV) self-sampling kits improve cervical cancer screening adherence. The HOME trial found information needs and anxiety among HPV-positive patients. We designed a STEP trial to test optimized intervention strategies with bolstered educational materials and a centralized nurse communicating positive results.
View Article and Find Full Text PDFUse of artificial intelligence for classification of fractures around the elbow in adults according to the 2018 AO/OTA classification system.
BMC Musculoskelet Disord
September 2025
Department of Clinical Sciences at Danderyds Hospital, Department of Orthopedic Surgery, Karolinska Institutet, Stockholm, 182 88, Sweden.
Background: This study evaluates the accuracy of an Artificial Intelligence (AI) system, specifically a convolutional neural network (CNN), in classifying elbow fractures using the detailed 2018 AO/OTA fracture classification system.
Methods: A retrospective analysis of 5,367 radiograph exams visualizing the elbow from adult patients (2002-2016) was conducted using a deep neural network. Radiographs were manually categorized according to the 2018 AO/OTA system by orthopedic surgeons.