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Improving Surgical Care and Recovery Plus
Enhanced Recovery Pathways

Are you interested in learning more about the VTE Toolkit or our work related to patient refusals? Contact Lindsey  Kreutzer at 312-503-3856 or at for more information. 

ISQIC Readiness Assessment Toolkit

This Readiness Assessment Toolkit was created based on the results of the readiness assessment tool as well as experiences observing ERP implementation and conducting interviews with stakeholders.


Each institution will require different strengthening activities depending on individual targeted improvement areas and the readiness of each institution’s departments. Even if a hospital already implemented ERP, this toolkit will further help galvanize the existing program by adding a framework to audit, troubleshoot, and control problematic areas of existing ERP to sustain high rates of protocol adherence.


Contact us at for more information. 

Enhanced Recovery Pathways (ERPs) are proven means of minimizing the physiological trauma of surgery to reliably shorten length of stay, decrease complications and costs, and improve patient experience.  Institutions have used ERP programs to decrease length of stay by 1-2 days per patient, decrease complication 

  1. Focusing on better education and management of patient expectations;

  2. Minimization of fasting before and after surgery;

  3. Minimizing opioids in lieu of opioid sparing pain medications;

  4. Minimizing IV fluids; and

  5. Promoting early and frequent ambulation and convalescence.

rates by approximately 50%, save over $6,000 per patient, decrease 30-day re-admission rates by over 40%, and improve patient satisfaction scores. Many people know this work by the name ERAS, or Enhanced Recovery After Surgery (ERAS). ERP is accomplished by

Implementing these changes to the way care is given requires transdisciplinary teamwork and buy-in.  All providers and patients need to be speaking the same language to optimally implement ERP.

AHRQ Safety Program for Improving Surgical Care and Recovery

The Johns Hopkins Armstrong Institute, in collaboration with the American College of Surgeons (ACS), is conducting a national quality improvement initiative funded and guided by the Agency for Healthcare Research and Quality (AHRQ) titled Improving Surgical Care and recovery (ISCR). ISCR is a

collaborative program to enhance the recovery of the surgical patient by supporting hospitals in implementing perioperative evidence-based pathways to meaningfully improve clinical outcomes, reduce hospital length of stay and improve the patient experience.

Improving Surgical Care and Recovery Plus

ISQIC is building on the ISCR initiative by strengthening hospitals’ readiness to implement ERP and providing additional implementation support and resources. ISQIC hospitals are completing a two-part self-diagnostic tool to assist them in identifying areas where the implementation core team and departments impacted by the pathway can be strengthened.

The ISQIC Readiness Assessment Toolkit then provides tools to build and strengthen the areas identified in the assessment.

For more information, contact us at

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