Enhanced Recovery Program Reduces Length of Stay & Improves Value for Patients Undergoing Elective Cesarean Section [33I]. (May 2018)

• Record Type: Journal Article
• Authors: Kett, Atilla; Cherot, Elizabeth
• Is Part Of: Obstetrics and gynecology. Volume 131(2018)Supplement 1
• Publication Date: 2018-05
• Subjects: Obstetrics -- Periodicals; Gynecology -- Periodicals; 618
• DOI: 10.1097/01.AOG.0000533459.24805.cb
• Languages: English
• ISSNs: 0029-7844

Abstract

Abstract : INTRODUCTION: Multiple obstetrical units in the United Kingdom introduced Enhanced Recovery Programs and demonstrated improved quality of care and significant savings with superior patient satisfaction. Our participation in the Perioperative Surgical Learning Collaborative and partnership with leading experts from the UK provides us with the unique opportunity to pioneer this pathway in the United States. METHODS: We enrolled low risk patients with the diagnosis of repeat Cesarean Section. Our team partnered with SeamlessMD, a leading provider of a clinical intelligence platform to develop the smartphone application to engage and empower our patients. Our solution has a wide range of capabilities, including a cross-platform application which accommodates patient education, reminders and the ability to perform remote monitoring and measure performance through an analytics dashboard including patient satisfaction and opioid use. RESULTS: We enrolled 110 patients in our first year. The average length of stay reduced from 3.7 to 2.45 days. We developed a financial model projecting the net direct variable costs and savings associated with the adoption of our program. Based on the implementation cost and daily direct variable cost savings, our Enhanced Recovery Program yielded a 296 % ROI during the first year and a projected 451% in subsequent years. CONCLUSION: Implementation of a Enhanced Recovery Program for patients undergoing elective Cesarean Sections can improve the value of care without forcing hospitals to incur a large expense. Cost savings associated with reduction in length of stay and improvement in patient outcomes and satisfaction can justify the cost associated with the implementation of the program.