Hackensack University Medical Center Protocols Enhance Patient Recovery Following Colorectal Surgery

Preoperative preparations and accelerated post-op processes set up patients for a smooth, expedient recovery experience

At Hackensack University Medical Center, the seeds for successful colorectal surgery recovery are planted weeks in advance of the procedure.

The colorectal surgery team observed that patients with less anxiety and more insight on what to expect during their surgery, hospital stay and transition home tend to experience a better and often more efficient recovery. So, the team, which is constantly seeking opportunities to refine care pathways for better outcomes, initiated a comprehensive patient education preparation initiative in advance of the hospital admission.

Preoperative counseling helps ensure patients and their family members know what to expect well before their surgery, resulting in greater comfort and less anxiety on procedure day, said Steven Lee-Kong, M.D., division chief of Colorectal Surgery at Hackensack University Medical Center. If a patient will require a stoma, patient education is now provided in advance when patients can be more focused—it used to be provided an hour before surgery.

The potential for same-day release and the advantages of recovering at home with appropriate family assistance versus rehabilitation facility care, including better infection rates, is discussed at this time as well. Home health supplies that a patient will need for recovery are preordered so family can fully focus on the patient during their transition home.

The team has taken several measures to ensure the shortest length of stay possible, including streamlining what pain medications are used to help prevent constipation and starting patients on solid food versus a liquid diet whenever possible. They also initiate activity and walking as soon as feasible after the procedure. The EMR provides automated prompts for recovery care pathways, such as cuing staff to initiate walking in a timely manner.

These multipronged approaches to gaining efficiency add up to a shorter recovery, with many patients clinically eligible for same-day release. This is dependent on a patient and family’s comfort with release. By preparing patients with education well in advance of their procedure and hospital stay, many feel more confident and comfortable with same-day release, Dr. Lee-Kong said.

They also receive post-discharge support, leaving with a comprehensive information booklet and 24-hour call access to reach a nurse or physician to answer any questions.

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