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Perioper Med (Lond). 2017 Mar 17;6:6. doi: 10.1186/s13741-017-0062-7. eCollection 2017.

American Society for Enhanced Recovery (ASER) and Perioperative Quality Initiative (POQI) joint consensus statement on measurement to maintain and improve quality of enhanced recovery pathways for elective colorectal surgery.

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UCLH NIHR Surgical Outcomes Research Centre and NIAA Health Services Research Centre, Royal College of Anaesthetists, London, UK.
Faculty of Medicine, University of Southampton, Southampton, UK.
Department of Anesthesiology, Stony Brook University School of Medicine, New York, USA.
Department of Surgery, Stony Brook University School of Medicine, New York, USA.
MD Anderson, Texas, USA.
Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina USA.
Department of Anesthesia, University of Toronto, Toronto, ON USA.
Department of Anaesthesia and Perioperative Medicine, University College London, London, UK.
Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, Tennessee USA.
Contributed equally



This article sets out a framework for measurement of quality of care relevant to enhanced recovery pathways (ERPs) in elective colorectal surgery. The proposed framework is based on established measurement systems and/or theories, and provides an overview of the different approaches for improving clinical monitoring, and enhancing quality improvement or research in varied settings with different levels of available resources.


Using a structure-process-outcome framework, we make recommendations for three hierarchical tiers of data collection.


Core, Quality Improvement, and Best Practice datasets are proposed. The suggested datasets incorporate patient data to describe case-mix, process measures to describe delivery of enhanced recovery and clinical outcomes. The fundamental importance of routine collection of data for the initiation, maintenance, and enhancement of enhanced recovery pathways is emphasized.


Colorectal surgery; Enhanced recovery; Enhanced recovery pathway; Outcomes; Quality

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