Breakthrough Improvement Collaborative for ColoRectal Cancer (BIC4CRC)

Study Overview
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Brief Summary
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Colorectal cancer is the most common cancer in Europe and the third worldwide. Approximately 1 in 20 men and 1 in 35 women will develop colorectal cancer at some moment in their life. In Flanders, in 2014, there was an increase in the detection of colorectal cancer with 21% compared to 2013. Early detection improves the prognosis for the patient. In this early stage, colorectal surgery is one of the most important treatments, but it is also complex and has a high complication rate. However, over the last decade, surgical care for patients with colorectal cancer has become more standardized. The use of structured care methods, such as care pathways and protocols, has helped in standardizing care processes. Specifically for patients with colorectal cancer, perioperative care has shifted with the implementation of Enhanced Recovery After Surgery (ERAS) programs. The goal of ERAS- protocols is to optimize the interventions during the perioperative hospitalization period and reduce postoperative complications. Despite the increasing evidence in favor of the use of these standardized protocols, adherence and implementation in daily practice remains challenging. The primary goal of this quality improvement project is to enhance the standardization of key interventions in the ERAS care process for patients undergoing colorectal surgery. Therefore, adherence to the ERAS-guidelines will be investigated and hospitals will receive feedback to set up improvement initiatives. Moreover, interactive group sessions and on-site training activities will stimulate knowledge sharing and define best practices.

Official Title
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BIC4CRC: Breakthrough Improvement Collaborative for ColoRectal Cancer

Conditions
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Colorectal Cancer

Intervention / Treatment
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* Other: Learning session 1
* Other: Learning session 2
* Other: Learning session 3
* Other: Learning session 4


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Minimum age of 18 years Elective admission for colorectal cancer surgery Exclusion Criteria: Emergency (not planned) admission for colorectal cancer surgery Patients diagnosed with severe dementia or severe concomitant disease that may affect very short term outcome and hence influence deviations from standard acute care

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Colorectal cancer<br> | Other: Learning session 1<br>* Learn form international report, Explain key interventions, Explain BIC methodology, Retrospective patient record analysis, Team measures<br>Other: Learning session 2<br>* Feedback report, Share (inter)national best practices, Discussion, set priorities, teaching and improvement, Retrospective patient record analysis<br>Other: Learning session 3<br>* Feedback report, Share best practices, Discussion, set priorities, teaching and improvement, Retrospective patient record analysis, Team measures<br>Other: Learning session 4<br>* Feedback report, Best practice symposium<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Length of stay | Number of days in the hospital | through study completion, an average of 4 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| 30-days readmission rate | Readmission rate | through study completion, an average of 4 months | 
| Mortality rate | Mortality rate | through study completion, an average of 4 months | 
| Complication rate | Re-intervention, wound complications, surgical site infection, anastomotic leak or stoma related complications | through study completion, an average of 4 months |