Marcus V. Ortega , Michael K. Hidrue , William T. Curry , Rachel Sisodia , Jeffrey Ecker , Jason H. Wasfy , Marcela G. del Carmen , Dan B. Ellis
{"title":"缩小不平等差距：ERAS 送货上门工具包","authors":"Marcus V. Ortega , Michael K. Hidrue , William T. Curry , Rachel Sisodia , Jeffrey Ecker , Jason H. Wasfy , Marcela G. del Carmen , Dan B. Ellis","doi":"10.1016/j.pcorm.2024.100389","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><p>To enhance adherence to Enhanced Recovery After Surgery (ERAS) protocols and address pre-operative preparation equity gaps, a system was developed to automatically mail chlorhexidine (CHG) and nutritional carbohydrate supplements (ERAS Kits) to surgical patients.</p></div><div><h3>Background</h3><p>This retrospective observational study focused on adult patients undergoing abdominal surgeries at a large academic hospital, using a pre-post design.</p></div><div><h3>Methods</h3><p>The study compared adherence to pre-operative ERAS pathways, involving nutritional supplements and chlorhexidine soap usage, before (September 2021-March 2022) and after (September 2022-March 2023) implementing automatic ERAS Kits mailing. A Chi square test analyzed adherence rates.</p></div><div><h3>Results</h3><p>Post-implementation, adherence to preoperative nutrition rose from 49.6 % to 57.7 % (<em>P</em> = 0.006), and surgical site preparation from 73.8 % to 78.7 % (<em>P</em> = 0.06). Notable improvements were seen among Black patients, Medicaid recipients, and those from lower-income neighborhoods in nutrition adherence, and among younger patients and Medicaid recipients in site preparation.</p></div><div><h3>Conclusion</h3><p>Mailing ERAS Kits directly to patients significantly enhanced compliance with preoperative protocols, demonstrating an effective strategy to improve care accessibility and reduce disparities for vulnerable groups.</p></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"35 ","pages":"Article 100389"},"PeriodicalIF":0.0000,"publicationDate":"2024-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Narrowing inequity gap: ERAS home delivery kit\",\"authors\":\"Marcus V. Ortega , Michael K. Hidrue , William T. Curry , Rachel Sisodia , Jeffrey Ecker , Jason H. Wasfy , Marcela G. del Carmen , Dan B. Ellis\",\"doi\":\"10.1016/j.pcorm.2024.100389\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objective</h3><p>To enhance adherence to Enhanced Recovery After Surgery (ERAS) protocols and address pre-operative preparation equity gaps, a system was developed to automatically mail chlorhexidine (CHG) and nutritional carbohydrate supplements (ERAS Kits) to surgical patients.</p></div><div><h3>Background</h3><p>This retrospective observational study focused on adult patients undergoing abdominal surgeries at a large academic hospital, using a pre-post design.</p></div><div><h3>Methods</h3><p>The study compared adherence to pre-operative ERAS pathways, involving nutritional supplements and chlorhexidine soap usage, before (September 2021-March 2022) and after (September 2022-March 2023) implementing automatic ERAS Kits mailing. A Chi square test analyzed adherence rates.</p></div><div><h3>Results</h3><p>Post-implementation, adherence to preoperative nutrition rose from 49.6 % to 57.7 % (<em>P</em> = 0.006), and surgical site preparation from 73.8 % to 78.7 % (<em>P</em> = 0.06). Notable improvements were seen among Black patients, Medicaid recipients, and those from lower-income neighborhoods in nutrition adherence, and among younger patients and Medicaid recipients in site preparation.</p></div><div><h3>Conclusion</h3><p>Mailing ERAS Kits directly to patients significantly enhanced compliance with preoperative protocols, demonstrating an effective strategy to improve care accessibility and reduce disparities for vulnerable groups.</p></div>\",\"PeriodicalId\":53468,\"journal\":{\"name\":\"Perioperative Care and Operating Room Management\",\"volume\":\"35 \",\"pages\":\"Article 100389\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-04-21\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Perioperative Care and Operating Room Management\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2405603024000232\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"Nursing\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Perioperative Care and Operating Room Management","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2405603024000232","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"Nursing","Score":null,"Total":0}
To enhance adherence to Enhanced Recovery After Surgery (ERAS) protocols and address pre-operative preparation equity gaps, a system was developed to automatically mail chlorhexidine (CHG) and nutritional carbohydrate supplements (ERAS Kits) to surgical patients.
Background
This retrospective observational study focused on adult patients undergoing abdominal surgeries at a large academic hospital, using a pre-post design.
Methods
The study compared adherence to pre-operative ERAS pathways, involving nutritional supplements and chlorhexidine soap usage, before (September 2021-March 2022) and after (September 2022-March 2023) implementing automatic ERAS Kits mailing. A Chi square test analyzed adherence rates.
Results
Post-implementation, adherence to preoperative nutrition rose from 49.6 % to 57.7 % (P = 0.006), and surgical site preparation from 73.8 % to 78.7 % (P = 0.06). Notable improvements were seen among Black patients, Medicaid recipients, and those from lower-income neighborhoods in nutrition adherence, and among younger patients and Medicaid recipients in site preparation.
Conclusion
Mailing ERAS Kits directly to patients significantly enhanced compliance with preoperative protocols, demonstrating an effective strategy to improve care accessibility and reduce disparities for vulnerable groups.
期刊介绍：
The objective of this new online journal is to serve as a multidisciplinary, peer-reviewed source of information related to the administrative, economic, operational, safety, and quality aspects of the ambulatory and in-patient operating room and interventional procedural processes. The journal will provide high-quality information and research findings on operational and system-based approaches to ensure safe, coordinated, and high-value periprocedural care. With the current focus on value in health care it is essential that there is a venue for researchers to publish articles on quality improvement process initiatives, process flow modeling, information management, efficient design, cost improvement, use of novel technologies, and management.
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