{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T13:29:40Z","timestamp":1789046980575,"version":"build-2803163510"},"reference-count":23,"publisher":"Springer Science and Business Media LLC","issue":"9","license":[{"start":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T00:00:00Z","timestamp":1784678400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T00:00:00Z","timestamp":1784678400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["OBES SURG"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>A standardized, multimodal Enhanced Recovery After Surgery (ERAS) protocol was implemented to improve postoperative outcomes in patients undergoing metabolic bariatric surgery (MBS). This quality improvement initiative evaluated the impact of a standardized, multimodal ERAS protocol on postoperative outcomes in MBS patients. Implemented at a community hospital where perioperative practices were inconsistent, this evidence-based pathway introduced a structured approach to perioperative care to enhance recovery and promote safer, more efficient outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A pre- and post-quality improvement study was conducted among adults undergoing MBS at a Midwestern community hospital following implementation of a structured ERAS protocol. Patients younger than 18 years and those with long-term opioid use were excluded. The Model for Evidence-Based Practice Change guided protocol development and implementation. Pre-implementation and post-implementation cohorts were compared across primary endpoints, including PONV incidence, opioid consumption, and length of stay (LOS). Mann\u2013Whitney U tests, and chi-square or Fisher\u2019s exact tests were used (\n                      <jats:italic>p<\/jats:italic>\n                      &lt; .05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      ERAS implementation resulted in a significant reduction in postoperative opioid use (Mdn\u2009=\u200922.5 vs. 80.0 MME; U\u2009=\u2009143.50,\n                      <jats:italic>p<\/jats:italic>\n                      &lt; .001). No significant differences were observed in PONV or LOS between groups. Protocol adherence was high (89.4%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>A structured, multimodal ERAS protocol was an effective quality improvement strategy for patients undergoing MBS at a community hospital. Standardizing perioperative care was associated with a significant reduction in opioid requirements without increasing PONV or LOS, supporting broader adoption of ERAS pathways in bariatric surgery programs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s11695-026-08846-4","type":"journal-article","created":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T13:52:01Z","timestamp":1784728321000},"page":"4618-4625","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Enhanced Recovery for Patients Undergoing Metabolic Bariatric Surgery in a Community Hospital: A Retrospective Pre\u2013Post Quality Improvement Study"],"prefix":"10.1007","volume":"36","author":[{"given":"Rachel","family":"Trotter","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda","family":"Shanks","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Howie","family":"Brown","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne M","family":"Miranda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,22]]},"reference":[{"key":"8846_CR1","unstructured":"World Health Organization. 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All data were de-identified before analysis in accordance with HIPAA Safe Harbor requirements [\n                      \n                      ].","order":1,"name":"Ethics","label":"Ethics Approval","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","label":"Consent to Participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":3,"name":"Ethics","label":"Consent for Publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}]}}