An Analysis of the Impact of the Enhanced Recovery After Surgery System for Colorectal Surgery at the University of Arkansas for Medical Sciences

The Enhanced Recovery After Surgery system for perioperative care of patients undergoing
major abdominal surgery, particularly colorectal surgery, was formed in Europe by a surgeon
named Henrik Kehlet in 1994. Dr. Kehlet observed that his patients undergoing colorectal
surgery were hospitalized postoperatively for extended periods of time due to prolonged
return of the normal intestinal physiology and of other bodily functions. He formulated a
system of perioperative care that focused on preserving and promoting faster return of normal
physiologic function of the human body following surgery.

The Enhanced Recovery After Surgery system has been implemented in the United States for
nearly a decade now, primarily at major academic institutions. Numerous publications exist
that report the dramatic positive impacts of this program on reducing postoperative hospital
length of stay, reducing 30-day hospital readmissions, and improving patient satisfaction.

The University of Arkansas for Medical Sciences implemented several components of the
Enhanced Recovery After Surgery system for colorectal surgery in June 2015. This is an
observational study to look at the impact that program (Group 1) in shortening hospital
length of stay, reducing postoperative narcotic consumption, lowering Visual Analog Scale
scores, decreasing the incidence of postoperative nausea and vomiting, and reducing 30-day
readmission when compared to patients who had colorectal surgery performed at University of
Arkansas for Medical Sciences prior to the implementation of the Enhanced Recovery After
Surgery system (Group 2).