• Alexander Norman, Krista Mahoney, Erin Ballah, Jeremy Pridham, Chris Smith, and Patrick Parfrey.
• From the Clinical Epidemiology Unit, Memorial University of Newfoundland, St. John's, Nfld. (Norman, Mahoney, Parfrey); Eastern Health, St. John's, Nfld. (Ballah); the Discipline of Anesthesia, Memorial University of Newfoundland, St. John's, Nfld. (Pridham); and the Discipline of Surgery, Memorial University of Newfoundland, St. John's, Nfld. (Smith).
• Can J Surg. 2020 May 21; 63 (3): E292-E298.

BackgroundIn March 2016, an Enhanced Recovery After Surgery (ERAS) initiative was implemented for all elective colorectal resections at an urban hospital in St. John's, Newfoundland and Labrador, Canada. An ERAS coordinator supervised and enforced guideline compliance for 6 months. The aim of this study was to evaluate the sustainability of the ERAS program after supervision of guideline compliance was eliminated.MethodsPatient outcomes and guideline compliance were compared between surgeries performed under standard practice (April 2014 to March 2015) and those performed during and after the implementation of the ERAS initiative (March 2016 to August 2016 was the implementation phase and September 2016 to February 2017 was the sustainability phase).ResultsHospital length of stay decreased from 7.26 days at baseline to 5.44 days during the implementation phase of the ERAS program (p < 0.001). There was no significant difference between length of stay at baseline and during the 6-month sustainability phase of the ERAS program (7.10 d). There were no significant differences in rates of readmission or mortality during and after implementation. Rate of ileus decreased significantly from 13.8% during the implementation phase to 4.6% during the sustainability phase (p = 0.036). Total guideline compliance increased from 52.2% at baseline to 80.7% during the implementation phase (p < 0.001), and decreased to 74.7% during the sustainability phase (p < 0.001). Adherence to postoperative guidelines regressed: 79.2% in the implementation phase and 68.6% in the sustainability phase (p < 0.001).ConclusionLa durée des séjours à l’hôpital a diminué après l’adoption du programme de RAAC, lorsque le coordonnateur du programme était présent. Les méthodes de maintien des lignes directrices après leur adoption seront cruciales au succès de programmes similaires à l’avenir.© 2020 Joule Inc. or its licensors.

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