Narrowing inequity gap: ERAS home delivery kit

Objective To enhance adherence to Enhanced Recovery After Surgery (ERAS) protocols and address pre-operative preparation equity gaps, a system was developed to automatically mail chlorhexidine (CHG) and nutritional carbohydrate supplements (ERAS Kits) to surgical patients. Background This retrospective observational study focused on adult patients undergoing abdominal surgeries at a large academic hospital, using a pre-post design. Methods The study compared adherence to pre-operative ERAS pathways, involving nutritional supplements and chlorhexidine soap usage, before (September 2021-March 2022) and after (September 2022-March 2023) implementing automatic ERAS Kits mailing. A Chi square test analyzed adherence rates. Results Post-implementation, adherence to preoperative nutrition rose from 49.6% to 57.7% (P=0.006), and surgical site preparation from 73.8% to 78.7% (P=0.06). Notable improvements were seen among Black patients, Medicaid recipients, and those from lower-income neighborhoods in nutrition adherence, and among younger patients and Medicaid recipients in site preparation. Conclusion Mailing ERAS Kits directly to patients significantly enhanced compliance with preoperative protocols, demonstrating an effective strategy to improve care accessibility and reduce disparities for vulnerable groups.