Colorectal Surgery Resource for Healthcare Providers and Leaders

Are you looking to reduce complications and support shorter hospital stays and safer transitions after colorectal surgery? Access the Enhanced Recovery Canada™ (ERC) Clinical Pathway for Colorectal Surgery. 

Based on surgical best practices, this clinical resource for colorectal surgeries provides guidance on all stages of the patient’s journey, from pre-admission to post discharge. It supports a multidisciplinary team approach and can be used by providers across the continuum of surgical care.

If implemented consistently, these strategies improve patient experience and reduce length of stay, complication rates and hospital readmissions – all valuable outcomes at a time when healthcare systems are under serious pressure.

This clinical resource was updated in 2023.

Download pathway

This resource also includes a template for physician orders as well as a data collection and measurement resource.

A complementary set of resources for patients undergoing colorectal surgery is also available.

What does this colorectal surgery resource cover?

Based on Enhanced Recovery After Surgery (ERAS) surgical best practices that put the quadruple aim within reach, the ERC colorectal clinical pathway is built on six core pillars:

1. patient and family engagement
2. nutrition management
3. fluid and hydration management
4. early mobility and physical activity
5. surgical best practices
6. pain management with fewer narcotics (multi-modal opioid-sparing analgesia)

Who can use this clinical pathway?

This clinical pathway has been developed for surgeons, anesthesiologists, nurses, dietitians, physiotherapists, other providers involved in the delivery of care of patients undergoing routine elective colorectal surgery, and healthcare leaders.

The purpose of this clinical pathway is to provide practitioners in Canada with evidence-informed strategies to improve surgical outcomes in colorectal patients.

The pathway applies to adult patients undergoing routine elective colorectal surgery performed with either open or minimally invasive routes (laparoscopic, or robotic).

What additional resources are available?

• A Guide to Patient Safety Improvement is an implementation resource that can support healthcare providers using enhanced recovery guidance.
• Fluid Management for ERAS Colorectal - this 30-minute interactive learning case assessing fluid management for better patient recovery outcomes was developed in partnership with the Royal College of Physician and Surgeons of Canada and is available to all healthcare professionals. All learning modules qualify for MOC Section 3 credits.
• Interview with Dr. Henrik Kehlet - Through a series of prospective cohort studies and randomized controlled trials initially using the model of colonic surgery, Dr. Kehlet demonstrated that modifying the perioperative surgical stress response and revising traditional surgical care could have a dramatic impact on postoperative recovery and shorten the length of hospital stay.
• Enhanced Recovery Canada and the ERAS principles.