Journal of the American College of Surgeons
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Multicenter Study
Care after colonic operation--is it evidence-based? Results from a multinational survey in Europe and the United States.
Despite clinical evidence showing that steps can be taken perioperatively to enhance postoperative recovery and decrease morbidity in colonic operation patients, there is no comprehensive information on how widespread such practices are, or the combination of such steps into effective multimodal rehabilitation (fast-track) colonic surgery programs to decrease hospital stay. This survey investigated clinical practice around colonic operations across Europe and the United States. ⋯ Strategies that can contribute to improved recovery and reduced complications after colonic operations do not appear to be applied optimally in clinical practice across Europe and the United States. These findings indicate a potential for major improvements in outcomes and reduction of costs if peri- and postoperative care can be adjusted to be in line with published evidence.
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Multicenter Study
The New England colorectal cancer quality project: a prospective multi-institutional feasibility study.
The need for risk-adjusted databases to benchmark quality is well recognized. Data entry is typically performed by physician surrogates who are variably involved in patient care and might be unable to capture key elements of patient care known only to the operating surgeon. The primary purpose of this study was to assess the feasibility of developing a multi-institutional, prospective, surgeon-initiated database and, secondarily, to compare the data collected with chart review. ⋯ Surgeons will participate in a collaborative, multi-institutional quality database. Compliance was variable, indicating that surgeon data entry cannot reliably replace other means of data collection. The surgeon might be able to provide key pieces of data, not otherwise available, that can be critical to understanding and improving outcomes.