EP637 - Standardized Colorectal Surgery Enhanced Recovery Pathway Implementation Leads to Improved Length of Stay and 30-Day Readmission Rate

ePoster Presenter(s)

• SL

  Steven Lee-Kong, MD

  Professor of Surgery , Division Chief of Colon and Rectal Surgery
  Hackensack University Medical Center
  Hackensack Meridian School of Medicine
  FORT LEE BORO, NJ, United States

  Disclosure information not submitted.

Senior Author(s)

• SL

  Steven Lee-Kong, MD

  Professor of Surgery , Division Chief of Colon and Rectal Surgery
  Hackensack University Medical Center
  Hackensack Meridian School of Medicine
  FORT LEE BORO, NJ, United States

  Disclosure information not submitted.

Author(s)

• HR

  Howard M. Ross, MD

  Chair/ Surgeon-in-Chief
  Hackensack University Medical Center
  Hackensack, New Jersey, United States

  Disclosure information not submitted.
• RM

  Ryan Moore, MD

  Assistant Professor of surgery
  Hackensack Meridian School of Medicine
  Cedar Grove, New Jersey, United States

  Disclosure information not submitted.
• GC

  Gregory Charak, MD

  Disclosure information not submitted.
• SG

  Samuel B. Grove, MBA, LSSMBB

  Director, Care Pathway Development
  Hackensack Meridian Health
  Beaufort, South Carolina, United States

  Disclosure information not submitted.
• MG

  Mary Grove, PhD, APN, ACNP-BC, ANP-BC, LSSBB

  Sr. Manager - Institute for Evidence-Based Care / Agile Institute
  Hackensack Meridian Health
  Beaufort, South Carolina, United States

  Disclosure information not submitted.
• AD

  Angelica R. Del Vecchio, PhD

  Medical Research Associate
  Hackensack University Medical Center
  Hackensack, New Jersey, United States

  Disclosure information not submitted.
• MP

  Mani Paliwal, MS, MBA

  Sr. Biostatistician
  Hackensack Meridian Health
  Edison, New Jersey, United States

  Disclosure information not submitted.

Purpose/Background: Standardized evidenced-based patient care pathways can improve outcomes in patients undergoing surgery. Development and implementation of pathways across a large health network poses specific challenges, including site-specific content development and implementation across a shared Electronic Health Record (EHR). Hackensack University Medical Center (HUMC) launched a Care Pathway (CP) Initiative to standardize care and improve patient outcomes in patients undergoing abdominal colorectal surgery. Here we outline our iterative implementation process, discuss lessons learned and offer a practical roadmap for other organizations.

Methods/Interventions: A newly developed care pathway became available for patients undergoing abdominal colorectal surgery at Hackensack University Medical Center in 2023. Benchmark comparisons for length of stay (LOS) and 30-day readmission were captured, and care pathway utilization from customized EHR dashboards informed CP development and ongoing refinement. Outcomes before and after pathway implementation were compared, and comparisons made between patients started on the CP and those who were not.

Results/Outcomes: The Colorectal CP was launched in April 2023. Post-colectomy patient data from the pilot hospital showed a 10.2% decrease in LOS and a 45.3% decrease in 30-day readmissions from 2022 (baseline) to 2023. Further improvements were seen in 2024, with a 43.5% decrease in LOS and a 30.8% decrease in 30-day readmissions, compared to 2022. Data also showed that patients on the CP compared to patients not on the CP had a lower LOS, 75.4% decrease (4.6 vs. 18.7 days) in 2023 and 69.1% (4.2 vs. 13.6 days) decrease in 2024 and lower 30-day readmissions, 25% decrease (7.8% vs. 10.4%) in 2023 and 32.8% decrease (9.8% vs. 14.6%) in 2024.

Conclusion/Discussion: Implementation of an evidence-based standardized care pathway for patients undergoing colorectal surgery is associated with improved Length of Stay and 30 day hospital readmission. Based on the favorable data above, current and future efforts focus on analyzing CP effectiveness, sustainability, and outcome drivers to inform expansion to high-volume conditions and broader network adoption.

Postoperative Length of Stay after Pathway Implementation
30-Day Hospital Readmission after Pathway Implementation