title: Results of introducing a rapid recovery program for total abdominal hysterectomy.
abstract: OBJECTIVE
  To review the impact of implementing a rapid recovery protocol (RRP) for patients undergoing abdominal hysterectomy.
  
  
  METHODS
  Metropolitan teaching hospital.
  
  
  METHODS
  Women undergoing abdominal hysterectomy for non-malignant indications.
  
  
  METHODS
  We conducted a retrospective review of consecutive cases performed during study periods before and after the introduction of an elective rapid recovery program emphasizing regional anesthesia. To control for universal improvements in medical practice, charts from a comparable local hospital without an RRP were also reviewed.
  
  
  RESULTS
  400 charts were reviewed and 366 cases met inclusion criteria and had sufficient information. Patients were well matched for demographic and medical variables between the study periods and between the institutions. The median length of stay (LOS) fell dramatically from 3 (range 1-12) days prior to RRP introduction to 1 (range 1-17) day after RRP (p < 0.001). LOS among patients at the 'control' institution remained unchanged at 3 days during the same time frame, indicating that external pressures contributed minimally to the observed changes. There were no significant differences in estimated blood loss, duration of surgery, or complication rate between the groups in either time period.
  
  
  CONCLUSIONS
  Introducing a rapid recovery program was associated with shorter hospitalization and did not appear to compromise surgical outcome.
authors.affiliation: Division of Gynecologic Oncology, Department of Obstetrics, Gynecology, and Women's Health, University of Minnesota, Minneapolis, Minn., USA.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Dickson
authors.forename: Peter A
authors.initials: PA
authors.lastname: Argenta
authors.forename: John A
authors.initials: JA
authors.lastname: Reichert
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000765:Anesthesia, Conduction; D016022:Case-Control Studies; D002985:Clinical Protocols; D005260:Female; D006784:Hospitals, Teaching; D006801:Humans; D007044:Hysterectomy / Q000534:rehabilitation*; D007902:Length of Stay; D008875:Middle Aged; D008910:Minnesota; D011183:Postoperative Complications; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult