How Mayo Clinic got staff on board with major surgical process changes  

Mackenzie Bean (Twitter) -

To decrease length of stay among surgical patients, Mayo Clinic created an Enhanced Recovery Pathway, which it strategically implemented across the organization and partnering institutions, David Larson, MD, division chair of colon and rectal surgery at Mayo, wrote in an article for Harvard Business Review.

Rochester, Minn.-based Mayo Clinic first implemented ERP protocols in two colorectal surgery practices in 2009, before gradually expanding the guidelines to Mayo's entire colorectal division in 2011. To get the initiative off the ground, Dr. Larson identified a handful of nurses and pharmacists to champion these changes and closely monitored progress.

From 2015-16, Mayo Clinic further expanded use of these protocols to the Mayo Clinic Care Network, a group of independent health systems that pay an annual fee for Mayo resources.

"Implementing the pathway within Mayo's own colorectal division was one thing; to change well-established processes at other institutions was quite another," Dr. Larson wrote.

The health system used several strategies to gain buy-in and trust among leaders at these institutions. For example, Mayo held a two-day meeting with the institutional teams leading these changes to discuss best practices and form a collaborative relationship. Mayo also scheduled monthly calls with each institution to address any concerns with the ERP process implementation.  

After the process was complete, Mayo Clinic Care Network reduced length of stay by 33.9 percent across all sites. One institution decreased this measure by 48.7 percent and had the lowest surgical readmission rate in its state.

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