Patient Recovery Outcomes Gains Achieved with Automated Workflows for Colorectal Surgery

Identifying and documenting best practices beginning weeks in advance of surgery leads to enhanced recovery success.

December 4, 2025

A systematized approach to proactive best practices in colorectal surgery at Hackensack University Medical Center is yielding significant length of hospital stay and 30-day readmission rate improvements.

The team reduced length of stay by 70%. Thirty-day readmissions dropped to 33% within 30 days of implementation compared to those not on the new care pathway.

The key: Helpful, timely reminders. Embracing this concept helped colorectal surgical teams at Hackensack University Medical Center adopt standardized workflows with automatic electronic medical record (EMR) cues to make sure all patients receive proactive, appropriate diagnostics, education and prophylactic medications at the best time to ensure the best outcome downstream.

“Historically, these are things that happened at the time of or right after surgery,” said Steven Lee-Kong, M.D., Chair of Colorectal Surgery, Hackensack University Medical Center.

While the surgical team already performed a time-out review of preoperative necessities, such as prophylactic antibiotics, this resulted in administering just before the incision or afterward—too late to realize full protection. So, the team began building more timely cues in the EMR.

Now, automatic prompts begin issuing weeks before a colorectal procedure, with patient education for patients who will need a temporary or permanent stoma and pre-ordering home care supplies. On the day of the procedure, the EMR automatically cues mechanical bowel prep and preoperative medications.

The pathway ensures a proactive approach with preoperative administration of pain medication, antibiotics and venous thromboembolism prophylaxis. Standard orders also guide the teams to withdraw urinary catheters at the earliest possible time, which now often occurs in the operating room and has decreased urinary tract infections, Dr. Lee-Kong said.

In addition, clinical teams rely on the new pathway to ensure patients ambulate and consume solid food within hours, minimize opiate use and schedule case management meetings.

Given these successful outcomes, the team is now focused on rolling out the standardized protocols to colorectal surgery teams across the entire Hackensack Meridian Health network.

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