For Physicians at Banner Gateway Medical Center  

Bowel Surgery Strategic Initiative Performance Report


On July 1, 2011 Banner Health began a Bowel Surgery Strategic Initiative which was based on the principles of “enhanced recovery after surgery.”  Underlying this initiative is a care pathway developed by the Surgery Clinical Consensus Group and approved as a Clinical Practice by Care Management.  As a basis for the strategic initiative, two key drivers of the pathway were used as process step metrics.  These two key drivers were early ambulation (a minimum of ambulating at least 3 times on post-op day #1) and early alimentation (a minimum of 200cc of liquids on post-op day #1). A composite score was measured for patients who achieved both the ambulation and alimentation goals.  During the course of this initiative, the composite scores for these key drivers increased from a baseline of 42.4% to 64.5%.  The table below is a summary of the outcomes seen as a result of this improvement in bowel surgery care process.  Statistically significant findings are noted*.

Outcome Pre 7/1/11 Post 7/1/11 % Difference
LOS 15.5 days 4.86 days -5.6%
30-day readmission 13.05% 10.22% -21.7%*
Complications 50.76% 44.88% -11.6%*
Mortality 0.51% 0.19% -62.7%
Costs $14,750 $14,738 -0.08%
Post-Op Ileus 27.54% 20.82% -24.4%

In 2012 the YTD composite score, for the first 3 months, is already 64.5% which is a 52% increase from the initial baseline score.  As we learn more about enhanced recovery after surgery we will continue to update and revise the care pathway as indicated.  The simplest way to insure your patients are cared for by this pathway is to utilize the “Colorectal – Postoperative Small and Large Bowel Procedure” CPOE order set. 

Congratulations on continuing to deliver high quality, evidence-based care in pursuit of improving outcomes for our patients!

Banner Gateway Medical Center
Higley Road and US 60
1900 N. Higley Road
Gilbert, Arizona 85234
(480) 543-2000
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