ACS 2018: Benchmark Early Compliance Utilizing the Enhanced Recovery After Surgery Interactive Audit System in Collaboration with the International ERAS Society

Boston, Massachusetts ( William M. Worrilow performed real time data monitoring of 21 cystectomy specific variables across three phases. They sought to evaluate compliance across three phases (pre, intra, and postoperative periods) that ultimately constitute overall compliance per ERAS society guidelines.

Prior to 1/1/2017, data from 55 cystectomy patients were collected before beginning our regimented ERAS protocol. Between 1/1/2017 and 9/30/2017, 46 consecutive, post-ERAS patients were entered into the EIAS. For this report, data were exported from the EIAS and statistically analyzed using Fisher’s exact tests.

They found significant compliance improvement across the three phases when comparing pre- and post-ERAS cohorts (see Table) with a total pre-ERAS compliance of 66.7% as compared to 85.7% post-ERAS (p<0.01). Specifically, an improvement was seen with pre-operative education, bowel prep, pre-operative oral carbohydrates, stimulation of gut, and mobilization on post-op days 1-2.

While limited numbers and early experience with ERAS has demonstrated excellent compliance, they are setting a benchmark rate of 85.7% compliance during the first year at this single institution. These results lend support for a team-integrated approach and analytical investment that enables real time monitoring and feedback. Such research is pivotal towards self-auditing (which is a component of ERAS) to implement and disseminate ERAS.

Presented by: William M. Worrilow, Levine Cancer Institute, Atrium Health, Charlotte, NC

Written by: Stephen B. Williams, MD., Associate Professor, Division of Urology, The University of Texas Medical Branch, Galveston, TX. and Ashish M. Kamat, MD. Professor, Department of Urology, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX at the 2018 American College of Surgeons Clinical Congress, October 21-25, 2018 in Boston, Massachusetts