PD02-02 ENHANCED RECOVERY AFTER SURGERY AND CARE COORDINATION PATHWAY AT CITY OF HOPE: DECREASED LENGTH OF STAY, READMISSIONS, AND COMPLICATIONS

• DOI: 10.1016/j.juro.2016.02.2076
• Publication Date: 2016-03-28T07:34:10Z
• Authors: Steven V. Kardos; Kevin G. Chan; Bertram Yuh; Jonathan Yamzon; Nora H. Ruel; Finly Zachariah; Clayton S. Lau; Laura Crocitto
• Keywords: 03 medical and health sciences; 0302 clinical medicine

You have accessJournal of UrologyGeneral & Epidemiological Trends Socioeconomics: Quality Improvement Patient Safety I1 Apr 2016PD02-02 ENHANCED RECOVERY AFTER SURGERY AND CARE COORDINATION PATHWAY AT CITY OF HOPE: DECREASED LENGTH STAY, READMISSIONS, COMPLICATIONS Steven V. Kardos, M.D. Kevin G. Chan, Bertram Yuh, Jonathan Yamzon, Nora H. Ruel, Finly Zachariah, Clayton S. Lau, andM.D. Laura CrocittoM.D. KardosSteven Kardos More articles by this author , ChanKevin Chan YuhBertram Yuh YamzonJonathan Yamzon RuelNora Ruel ZachariahFinly Zachariah LauClayton Lau and CrocittoLaura Crocitto View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.2076AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION OBJECTIVES Bladder cancer is the second most common urologic malignancy with over 73,350 new cases diagnosed annually which incidence increasing in elderly. Radical cystectomy (RC), gold standard for muscle invasive disease, carries a particularly high risk morbidity mortality, as well protracted length stay (LOS) increased readmission rates. Furthermore, 2013, Institute Medicine (IOM) declared care US national crisis priority improve quality through coordination. Simultaneously, enhanced recovery after surgery (ERAS) protocols surfaced coordinated, evidence-based models designed standardize medical care, outcomes, lower healthcare costs. At City Hope (COH), we evaluated our ERAS coordination pathway. METHODS In April 2014, an pathway bladder was launched at COH emphasis on perioperative patients (pts) from multi-disciplinary team perspective. Preoperatively, pts undergo orientation stoma education, goals treatment expectations. The clinically focuses avoidance bowel preparation, early feeding mobilization, minimizing narcotic pain management, u-opioid antagonists. On discharge, are closely monitored via scheduled phone calls clinic visits. metrics including LOS, complications, readmissions reported median interquartile range (IQR) along descriptive statistics chi-square Wilcoxon rank-sum tests. RESULTS Table 1 illustrates demographic clinical characteristics cohorts. Since implementation, LOS statistically significant between cohorts 6 days compared 8 those preceding (p=0.0007). complication rates decreased 67.5% 50% 35% 30%, respectively. Dehydration urinary tract infection (UTI) accounted 17.9% 21.4% prior pathway, while UTI occurred 5% readmitted adhering CONCLUSIONS Our has reduced without increase nor © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e51 Advertisement Copyright Permissions© 2016MetricsAuthor Information Expand PDF downloadLoading ...