Implementation of an Enhanced Recovery Protocol Attenuates Disparities in Pediatric Surgical Care.
Pediatric enhanced recovery protocol substantially reduced preoperative care disparities.
Implementation of an Enhanced Recovery Protocol Attenuates Disparities in Pediatric Surgical Care.
ERPs have narrowed disparities in adult surgical care, but their impact in pediatric surgery is unknown.
To assess whether implementation of an enhanced recovery protocol (enhanced recovery protocol) reduces racial and ethnic disparities in pediatric surgical care.
We performed a secondary analysis of the ENhanced Recovery in CHildren Undergoing Surgery (ENRICH-US) trial, a stepped-wedge, cluster-randomized trial across 18 pediatric surgery sites.
Enhanced recovery protocol delivery increased from 11.4 elements at baseline to 13.3 during implementation to 14.0 during the sustainability phase (P<0.001).
Among race/ethnicity categories, significant disparities were identified only between Hispanic/Latino and non-Hispanic White patients.
Hispanic/Latino patients received fewer elements than non-Hispanic White patients across all phases; however, disparities narrowed from 1.1 at baseline (Hispanic/Latino: 10.4 vs. non-Hispanic White: 11.6; P=0.003) to 0.5 elements during the sustainability phase (Hispanic/Latino: 13.5 vs. non-Hispanic White: 14.0; P=0.24).
Applied implementation of a pediatric enhanced recovery protocol was associated with increased delivery of evidence-based care for all patients and substantial attenuation of baseline disparities for Hispanic/Latino children.