Highlights
A multicenter stepped-wedge cluster-randomized trial across 18 US hospitals found that introducing a 21-element enhanced recovery protocol for children undergoing elective gastrointestinal surgery did not significantly reduce postoperative length of stay at the phase level.
Implementation was successful in one important respect: patient-level adherence increased substantially across baseline, implementation, and sustainment phases, indicating that centers were able to incorporate many protocol elements into routine care.
