Reducing postoperative length of stay for colorectal cancer stoma creation patients

Approximately 2,500 ostomy creation surgeries occur in Ireland annually for the treatment of colorectal cancer, inflammatory bowel disease, diverticular disease, or trauma (Romero, 2021). An increased length of stay on surgical wards leads to increased demands on both surgical teams and hospital resources. A selected cohort (12) of patients underwent stoma creation surgery for the treatment of colorectal cancer at the project site between 1st June and 31st December 2021. Of this patient cohort, the average length of stay was 18 days. 50% (n=6) had an extended length of stay due to postoperative complications. The average postoperative stay for patients undergoing stoma creation surgery for colorectal cancer is 9 days. The data suggests that the most common complications were due to ileus and electrolyte imbalances. The average length of stay for postoperative stoma creation patients was found to be 9 days. Using Lean Six Sigma tools and the DMAIC (Define, Measure, Analyse, Improve, Control) framework, the root causes of the increased length of stay. The avoidable complications were outlined, and a plan was developed to identify complications at an early stage. The planned improvement should initiate a tailored Enhanced Recovery After Surgery pathway. This pathway should include ‘prehabilitation’ and strong cooperation between the multidisciplinary team. This model aims to reduce patients’ postoperative length of stay and reduce demands on the multidisciplinary team charged with their care.