Quality and Outcomes Research
Quality and outcomes research is instrumental in maintaining the high level of clinical care provided at the Division of Colorectal Surgery. According to P. Ravi Kiran, MBBS, Chief and Program Director, Division of Colorectal Surgery, quality and outcomes research continually informs and improves the division’s clinical practices. “Every patient’s care is monitored for measures of quality including complication rates, length of stay, short- and long-term outcomes, and overall patient experience. This information is used to improve patient care and decrease costs,” says Dr. Kiran. “In addition to using the national guidelines, we constantly reevaluate how we take care of patients based on real-time information from our surgeons.”
Dr. Kiran is well regarded for his expertise in outcomes research, and the Division is considered a leader in outcomes-related expertise in NY and the country. The Division is one of the few in the country that houses an institutional outcomes database that encompasses research, surgical quality and education. In addition to being presented at national and international conferences and published in major surgical journals, data from NYP/Columbia related studies have been incorporated into national guidelines for use for all patients in the country.
One direct example of how the research program benefits patients is its recent work concerning bowel preparation before colorectal surgery. For 50 years, there has been no consensus about the best way to prepare patients before colorectal resection (removal of a portion of the colon), and so Dr. Kiran and his colleagues studied the problem. The group found that a combination of a mechanical bowel preparation and oral antibiotics reduces a patient’s risk of surgical site infection or leakage by half. In addition to reporting these findings at the 2015 American Surgical Association meeting this spring, the division has incorporated them into a protocol that is already improving patients’ outcomes.
Dr. Kiran’s study is one of the largest to date to examine bowel preparation, and provides the best evidence available to date on the topic.
Six colorectal fellows are currently performing other research on topics including diverticulitis, colon cancer, ulcerative colitis, Crohn’s disease and surgical outcomes following colon and rectal resection procedures.