Liu et al1 are to be commended on evaluating the large-scale implementation of an enhanced recovery after surgery (ERAS) program for elective colorectal resections and emergent hip fracture procedures across 20 northern California Kaiser Permanente hospitals. Using pre-post difference-in-difference methods, this multidisciplinary, multihospital implementation of an ERAS program successfully altered processes and outcomes of surgical care. Among patients who underwent emergent hip fracture procedures, the ERAS program was associated with significant absolute and relative decreases in hospital length of stay and increases in rates of discharge to home. Among those who underwent colorectal resections, ERAS implementations were associated with a reduction in hospital mortality, length of stay, and development of major complications. Interestingly, ERAS implementation did not affect readmission rates after either procedure.
Bayasi M, Al-Refaie W. Enhanced Surgical Recovery Through Enhanced Research From Integrated Health Systems. JAMA Surg. Published online May 10, 2017e171051. doi:10.1001/jamasurg.2017.1051