Abstract
Introduction: 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. Methods: 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. Results: 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. Conclusions: 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.
Original language | English (US) |
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Pages (from-to) | 204-212 |
Number of pages | 9 |
Journal | Journal of Surgical Research |
Volume | 284 |
DOIs | |
State | Published - Apr 2023 |
Funding
This research was supported by Crohn's & Colitis Foundation's Litwin IBD Pioneers Award (PI: Raval; Award # 571096 ) and Digestive Health Foundation at Northwestern Medicine (Co-PIs: Raval & Balbale). Additional Support was provided by the Eunice Kennedy Shriver National Institute of Child Health & Human Development of the National Institutes of Health under Award Number R01HD099344 . The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
Keywords
- enhanced recovery protocols
- gastrointestinal surgery
- implementation
- pediatric
- qualitative research
ASJC Scopus subject areas
- Surgery