TY - JOUR
T1 - Interdepartmental Spread of Innovations
T2 - A Multicentre Study of the Enhanced Recovery After Surgery Programme
AU - de Groot, Jeanny J. A.
AU - Maessen, José M. C.
AU - Dejong, Cornelis H. C.
AU - Winkens, Bjorn
AU - Kruitwagen, Roy F. P. M.
AU - Slangen, Brigitte F. M.
AU - van der Weijden, Trudy
AU - on behalf of all the members of the study group
AU - Bekkers, R. L. M.
AU - Boss, E. A.
AU - van Dorst, E. B. L.
AU - van Driel, W. J.
AU - Fons, G.
AU - Gaarenstroom, K. N.
AU - Gerestein, C. G.
AU - van Haaften, M.
AU - van Haaften-de Jong, A. M. L. D.
AU - de Haan, H. H.
AU - van Hamont, D.
AU - Hermans, R. H. M.
AU - Hofhuis, W.
AU - Hofman, L. N.
AU - Martens, J. E.
AU - Mertens, H.
AU - Pijlman, B. M.
AU - Pijnenborg, J. M. A.
AU - Reesink-Peters, N.
AU - Roes, E. M.
AU - Schagen van Leeuwen, J. H.
AU - Snijders, M. P. L. M.
AU - Vencken, P. M. L. H.
PY - 2018/8/1
Y1 - 2018/8/1
N2 - Background: Spread of evidence-based innovations beyond pioneering settings is essential to improve quality of care. This study aimed to evaluate the influence of a national project to implement ‘Enhanced Recovery After Surgery’ (ERAS) among colorectal teams on the spread of this innovation to gynaecological procedures. Methods: A retrospective observational multicentre study was performed of a consecutive sample of patients who underwent major elective gynaecological surgery in 2012–2013. Ten Dutch hospitals (294 patients) had participated in a colorectal breakthrough project implementing ERAS on a nationwide basis and were assigned to the intervention group. Thirteen hospitals (390 patients) that had not participated in this project acted as controls. Outcome measures were time to functional recovery and total length of postoperative hospital stay. Multilevel models adjusted for clustering and baseline demographics were used for analysis. The uptake of ten selected perioperative care elements was evaluated for each hospital. Results: The estimated mean difference (95% confidence interval) between the intervention and control hospitals was −0.3 (−0.9 to 0.3) days in the time to recovery and 0.2 (−0.8 to 1.3) days in the total length of hospital stay. The mean (± standard deviation) absolute rate of implemented perioperative care elements per hospital was 28.9 ± 14.9% in the control, versus 29.3 ± 11.1% in the intervention group (p = 0.934). Conclusion: Initial implementation effects seem to be restricted to the participating teams and do not automatically spread to other surgical teams in the same hospital.
AB - Background: Spread of evidence-based innovations beyond pioneering settings is essential to improve quality of care. This study aimed to evaluate the influence of a national project to implement ‘Enhanced Recovery After Surgery’ (ERAS) among colorectal teams on the spread of this innovation to gynaecological procedures. Methods: A retrospective observational multicentre study was performed of a consecutive sample of patients who underwent major elective gynaecological surgery in 2012–2013. Ten Dutch hospitals (294 patients) had participated in a colorectal breakthrough project implementing ERAS on a nationwide basis and were assigned to the intervention group. Thirteen hospitals (390 patients) that had not participated in this project acted as controls. Outcome measures were time to functional recovery and total length of postoperative hospital stay. Multilevel models adjusted for clustering and baseline demographics were used for analysis. The uptake of ten selected perioperative care elements was evaluated for each hospital. Results: The estimated mean difference (95% confidence interval) between the intervention and control hospitals was −0.3 (−0.9 to 0.3) days in the time to recovery and 0.2 (−0.8 to 1.3) days in the total length of hospital stay. The mean (± standard deviation) absolute rate of implemented perioperative care elements per hospital was 28.9 ± 14.9% in the control, versus 29.3 ± 11.1% in the intervention group (p = 0.934). Conclusion: Initial implementation effects seem to be restricted to the participating teams and do not automatically spread to other surgical teams in the same hospital.
UR - https://www.scopus.com/pages/publications/85044954300
UR - https://www.ncbi.nlm.nih.gov/pubmed/29387957
U2 - 10.1007/s00268-018-4495-z
DO - 10.1007/s00268-018-4495-z
M3 - Article
C2 - 29387957
SN - 0364-2313
VL - 42
SP - 2348
EP - 2355
JO - World journal of surgery
JF - World journal of surgery
IS - 8
ER -