The present systematic review suggests that ERPs in colorectal and pancreas surgery are associated with cost savings compared to conventional perioperative management .
Enhanced recovery programs ( ERPs ) have been shown to improve postoperative outcomes after abdominal surgery .
This study aim ed to review the current literature to assess if ERPs in colorectal , pancreas , and liver surgery induce cost savings .
Implementation of a clinical pathway decreases length of stay and hospital charges for patients undergoing total colectomy and ileal pouch/anal anastomosis.
BACKGROUND Clinical pathways are increasingly being used by hospitals to improve efficiency in the care of certain patient population s ; however , little prospect i ve data are available to support their use . This study examined whether using a clinical pathway for patients undergoing ileal pouch/anal anastomosis , a complex procedure in which we had extensive practical experience , affected hospital charges or length of stay ( LOS ) . METHODS A clinical pathway was developed to serve patients undergoing elective total colectomy and ileal pouch/anal anastomosis .  All operations were performed by two attending physicians ( J.E.F. , M.S.N. ) . Before implementation , 10 pilot patients were prospect ively monitored to ensure that hospital charges were accurately generated . In addition , charge audits were performed by an outside agency to verify the accuracy of the hospital bills . The pathway was then implemented , and 14 patients were prospect ively analyzed . RESULTS In all patients the principal diagnosis was ulcerative colitis , with the exception of three patients with familial polyposis .  Mean external audit charges were within 2 % of the hospital bills ; therefore the hospital bills were used in all calculations . The mean LOS decreased from 10.3 days to 7.5 days ( p = 0.046 ) for patients on the pathway versus pilot patients . Mean hospital charges also decreased significantly , from $ 21,650 to $ 17,958 per patient ( p = 0.005 ) . CONCLUSIONS Implementation of a clinical pathway , even for an operation in which the surgeon has much experience , is an effective method for reducing LOS and charges for patients . This is likely the result of interdisciplinary cooperation , elimination of unnecessary interventions , and streamlined involvement of ancillary services . These results support the development of clinical pathways for procedures that involve routine preoperative and postoperative care . In addition , the benefits of clinical pathways should increase proportionally with increasing case volume for a particular procedure
The present systematic review suggests that ERPs in colorectal and pancreas surgery are associated with cost savings compared to conventional perioperative management .
Enhanced recovery programs ( ERPs ) have been shown to improve postoperative outcomes after abdominal surgery .
This study aim ed to review the current literature to assess if ERPs in colorectal , pancreas , and liver surgery induce cost savings .