No registrations found.
ID
Source
Brief title
Health condition
Perioperative care; elective abdominal surgery, gynaecological oncology
Perioperatieve zorg, electieve abdominale chirurgie, gynaecologische oncologie
Sponsors and support
Intervention
Outcome measures
Primary outcome
The primary outcome is length of postoperative hospital stay.
Secondary outcome
Additional outcome measures will be length of recovery, guideline adherence and implementation costs. An effect, economic, and process evaluation will be conducted throughout the trial.
Background summary
The Enhanced Recovery After Surgery (ERAS) programme is an evidence-based perioperative management programme that aims at an early recovery after major surgical trauma and consequently at a reduced length of hospitalisation. The ERAS programme proved to be safe and is already standard care in colorectal surgery for many years. This study focuses on large scale implementation of the ERAS programme in major gynaecological surgery in the Netherlands.
Study objective
To implement the Enhanced Recovery After Surgery (ERAS) programme in elective gynaecological surgery on large scale in an (cost) effective manner is challenging. The traditional used breakthrough method for health care improvement on large scale showed at the best moderately positive effects and requires considerable investments in professional time and energy. The objective of this study is to compare the breakthrough programme with a new stepped approach designed to deliver an optimal effect of implementation efforts at the lowest possible costs.. It is hypothesised that the stepped implementation strategy is more effective compared to the traditional breakthrough methodology for the nationwide uptake of evidence based best practice.
Study design
- Retrospective baseline measurement
- Prospective monitoring of patient characteristics, process indicators and outcome measures during the one year implementation period.
- Evaluation of the effectiveness of both strategies every three months after every step or teaching session and at the end of the project. The timing of the teaching sessions of the breakthrough project will be synchronously with the timing of implementation steps.
Intervention
The intervention group receives an innovative stepped implementation strategy comprising four levels of intensity of support. Implementation starts with generic low-cost activities and builds up to the highest level of tailored and labour-intensive activities. The decision for a stepwise increase in intensive support will be based on the success of implementation so far.
In the control arm hospitals receive the traditional breakthrough strategy with educational sessions and the use of plan-do-study-act cycles for planning and executing local improvement activities.
J.J.A Groot, de
Maastricht 6200 MD
The Netherlands
0031 (0)43 3882317
jeanny.degroot@maastrichtuniversity.nl
J.J.A Groot, de
Maastricht 6200 MD
The Netherlands
0031 (0)43 3882317
jeanny.degroot@maastrichtuniversity.nl
Inclusion criteria
All Dutch hospitals that are authorised in 2013 to perform major abdominal surgery in gynaecologic oncology patients are eligible for inclusion.
Exclusion criteria
The hospitals that are already participating in a structured and documented local perioperative improvement programme will be excluded from this study to avoid interference between programmes.
Design
Recruitment
Followed up by the following (possibly more current) registration
No registrations found.
Other (possibly less up-to-date) registrations in this register
No registrations found.
In other registers
| Register | ID |
|---|---|
| NTR-new | NL3896 |
| NTR-old | NTR4058 |
| Other | ZonMW : 837003002 |
| ISRCTN | ISRCTN wordt niet meer aangevraagd. |