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The objective of the study is to assess retrospectively the effect of an awareness-raising phase in favour of Enhanced Recovery After Surgery across the Assistance Publique-Hopitaux Paris institution and to explore the determinants of compliance with modalities of Enhanced Recovery After Surgery. This multicenter study is performed for three types of surgery: total knee arthroplasty, left colectomy and hysterectomy.
The primary goal of the study is to quantify the effect of an awareness-raising phase in favour of Enhanced Recovery After Surgery which was organized in 2016 within the public hospitals in Paris (Assistance Publique - Hôpitaux de Paris).
The study aims to document and compare the compliance with fast track modalities and its impact for the year before (2015) and the year following (2017) the awareness-raising phase. Durations of hospital stay, compliance with recommendations, benefits on lowering complication rates and cost reductions will be studied for three types of interventions: total knee arthroplasty, left colectomy and hysterectomy.
Preoperative information provided to patients, counselling and physical optimisation will be evaluated through a survey among physicians whereas compliance with pre-, intra- and postoperative patient management guidelines will be retrospectively retrieved from the medical records of randomly selected patients. Survival and hospital trajectories will be obtained through the centralised national medical data system.
Three groups of patients having underwent total hip prosthesis, ovariectomy or gastrectomy in the same years (2015 and 2017) will serve as control groups, as for these surgeries no specific program has been implemented toward any practice change.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| 2015 Total knee arthroplasty, hysterectomy or left colectomy | Group of patients having a total knee arthroplasty, hysterectomy or left colectomy in 2015 |
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| 2017 Total knee arthroplasty, hysterectomy or left colectomy | Group of patients having a total knee arthroplasty, hysterectomy or left colectomy in 2017 |
| |
| 2015 Total hip prosthesis, ovariectomy or gastrectomy | Group of patients having total hip prosthesis, ovariectomy or gastrectomy in 2015 |
| |
| 2017 Total hip prosthesis, ovariectomy or gastrectomy | Group of patients having total hip prosthesis, ovariectomy or gastrectomy in 2017 |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| One year before awareness-raising phase in favour of Enhanced Recovery After Surgery | Procedure | One year before awareness-raising phase in favour of Enhanced Recovery After Surgery |
| Measure | Description | Time Frame |
|---|---|---|
| Duration of hospital stay | The average duration of hospital stay will be compared for the year before (2015) and following (2017) the awareness-raising program implemented in 2016 for patients with knee arthroplasty, hysterectomy or left colectomy. | through study completion, an average of 1 year |
| Measure | Description | Time Frame |
|---|---|---|
| Compliance with modalities of Enhanced Recovery After Surgery program | Modalities of Enhanced Recovery After Surgery recommendations will be compared between the year before (2015) and the year following (2017) the awareness-raising program implemented in 2016. | through study completion, an average of 1 year |
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Inclusion criteria:
Exclusion criteria:
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Adult patients who underwent surgery (total knee arthroplasty, colectomy, hysterectomy and total hip prosthesis, ovariectomy or gastrectomy for the control groups) in 2015 or 2017.
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Dominique Fletcher, MD, PhD | Contact | +33 1 49 09 54 23 | dominique.fletcher@aphp.fr | |
| Anissa Belbachir, MD | Contact | +33 1 58 41 15 17 | anissa.belbachir@aphp.fr |
| Name | Affiliation | Role |
|---|---|---|
| Dominique Fletcher, MD, PhD | Service d'anesthésie-réanimation chirurgicale, Hôpital Ambroise Paré | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Service d'anesthésie-réanimation chirurgicale, Hopital Ambroise Paré | Recruiting | Boulogne-Billancourt | Hauts-de-seine | 92100 | France |
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| One year after awareness-raising phase in favour of Enhanced Recovery After Surgery | Procedure | One year after awareness-raising phase in favour of Enhanced Recovery After Surgery |
|
| No specific program toward improving practices | Procedure | No specific program toward improving practices |
|
| Number of surgery related complications |
Benefits on lowering complications rates |
| through study completion, an average of 1 year |
| Costs per patient | To determine if the awareness-raising program implemented in 2016 has produced a significant cost per patient reduction. The total cost for hospitalization, readmission and surgery related complications will be assessed. | through study completion, an average of 1 year |