American Society for Enhanced Recovery (ASER) and Perioperative Quality Initiative (POQI) joint consensus statement on measurement to maintain and improve quality of enhanced recovery pathways for elective colorectal surgery.
BACKGROUND
This article sets out a framework for measurement of quality of care relevant to enhanced recovery pathways (ERPs) in elective colorectal surgery. The proposed framework is based on established measurement systems and/or theories, and provides an overview of the different approaches for improving clinical monitoring, and enhancing quality improvement or research in varied settings with different levels of available resources.


METHODS
Using a structure-process-outcome framework, we make recommendations for three hierarchical tiers of data collection.


CONCLUSIONS
Core, Quality Improvement, and Best Practice datasets are proposed. The suggested datasets incorporate patient data to describe case-mix, process measures to describe delivery of enhanced recovery and clinical outcomes. The fundamental importance of routine collection of data for the initiation, maintenance, and enhancement of enhanced recovery pathways is emphasized.
UCLH NIHR Surgical Outcomes Research Centre and NIAA Health Services Research Centre, Royal College of Anaesthetists, London, UK.
S Ramani
SR
Moonesinghe
Faculty of Medicine, University of Southampton, Southampton, UK.
Michael P W
MPW
Grocott
Department of Anesthesiology, Stony Brook University School of Medicine, New York, USA.
Elliott
E
Bennett-Guerrero
Department of Surgery, Stony Brook University School of Medicine, New York, USA.
Roberto
R
Bergamaschi
MD Anderson, Texas, USA.
Vijaya
V
Gottumukkala
Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina USA.
Thomas J
TJ
Hopkins
Department of Anesthesia, University of Toronto, Toronto, ON USA.
Stuart
S
McCluskey
Department of Anesthesiology, Stony Brook University School of Medicine, New York, USA.
Tong J
TJ
Gan
Department of Anaesthesia and Perioperative Medicine, University College London, London, UK.
Michael Monty G
MMG
Mythen
Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, Tennessee USA.
Andrew D
AD
Shaw
Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina USA.
Timothy E
TE
Miller
Colorectal surgery; Enhanced recovery; Enhanced recovery pathway; Outcomes; Quality