Abstract
Objectives: A lack of specialty specific evidence as well as a perceived need for additional resources may deter many healthcare institutions from instituting ERAS®. Our goal was to create an interactive platform to monitor outcomes and resource utilization in real time during our implementation of ERAS® for pancreaticoduodenectomy (PD). Methods: In 2015 we began developing an interactive platform to monitor outcomes (clinical, financial, and patient reported) that is updated in real time from our departmental REDCAP™ data repository. This platform generates an “optimization index” termed the Carolinas Optimization Index (COPI). The index is currently validated for clinical and financial outcomes alone. We utilized COPI to monitor ERAS® implementation in real time. Results: The Carolinas Optimization Index (COPI) was 49.05 on average prior to implementation of ERAS® derived from a clinical factor of 49.85 and a financial factor of 47.41 (Table 1). After implementation of ERAS® in September 2015, the COPI steadily improved reflecting improved outcomes and decreased resource utilization with an overall average COPI of 50.87 derived from a clinical factor of 50.13 and a financial factor of 52.38. COPI has continued to improve, surpassing 52.00 over the last 3 months monitored from continued improvement of both clinical and financial outcomes.Table 1Clinical, Financial, and COPI indices calculated over equivalent time periods prior to and after ERAS® implementation in September 2015.IndexPre-ERAS (1/2014-8/2015)Post-ERAS (9/2015-1/2017)Clinical Outcomes Index49.8550.13Financial Outcomes Index47.4152.38Carolinas Optimization Index (COPI)49.0550.87 Open table in a new tab Conclusion: Along with the ERAS® Interactive Audit System (EIAS) for audit and compliance monitoring, the Carolinas Optimization Index has been a valuable tool to monitor improvements in clinical outcomes and resource utilization during implementation of ERAS® for PD at our institution. We expect that monitoring and utility of our interactive software platform will further improve with the addition of patient reported outcomes to the current index. Disclosure of Interest: None declared.
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