학술논문

Implementation of Enhanced Recovery Protocols for Gastrointestinal Surgery in Children: Practical Tools From Key Stakeholders.
Document Type
Article
Source
Journal of Surgical Research. Apr2023, Vol. 284, p204-212. 9p.
Subject
*PEDIATRIC surgery
*CHILD patients
*LENGTH of stay in hospitals
*HOSPITAL administration
*PHYSICIANS' assistants
*GASTROINTESTINAL surgery
Language
ISSN
0022-4804
Abstract
We explored patient, caregiver, and provider recommendations for development of a tool kit to implement enhanced recovery protocols (ERPs) for pediatric patients undergoing gastrointestinal surgery. ERPs are widely used for adults to decrease hospital length of stay, hospital costs, and complications while hastening patient recovery after surgery. With limited data available for ERPs among pediatric populations informed modification of adult ERPs is needed to facilitate successful implementation for pediatric surgery. Using a qualitative research design, semistructured interviews were conducted with hospital-based teams including surgeons, anesthesiologists, gastroenterologists, nursing, and physician assistants. Four in-person focus groups were held at two pediatric hospitals with patients and caregivers. Codes were developed and applied to interview and focus groups transcripts for structural content analysis. Thematic analysis guided by the Active Implementation Framework, included recommendations that informed ERP implementation tool kit development. Key components of the ERP tool kit included the need for a structured and systematic approach, leadership support from key champions, and buy-in from surgical partners and hospital management. Providers identified the need for multimodal educational materials on ERP elements for staff and patients; use of uniform checklists, care sets and an electronic repository to collect outcome data for quality assurance assessment. Patients and caregivers endorsed expansion of the team to include child-life specialists, nutritionists, and patient-parent supporters to help navigate the surgical experience. This study is the first to leverage key input from patients, caregivers, and providers to identify practical components for an ERP implementation tool kit for children undergoing gastrointestinal surgery. • The process of implementing enhanced recovery protocols (ERPs) in surgical settings can be facilitated using key stakeholder input to develop functional tool kits. • This study used input from patients, caregivers, and providers to identify components for an ERP implementation tool kit for children undergoing gastrointestinal surgery. • The ERP Implementation tool kit created during this study can be locally modified and customized to fit the needs of surgery centers serving children. [ABSTRACT FROM AUTHOR]