Developing Pilot Postoperative Guidelines for Improved Functional Outcomes After High-Risk Cancer Surgery

This is a prospective, feasibility, and effectiveness trial to be conducted at The University of Alabama at Birmingham. We plan to develop algorithmic guidelines focused on proactive support of surgical recovery and will then recruit surgeons who care for adults undergoing high-risk abdominal surgery for cancer to study the preliminary effectiveness of implementing the algorithmic guidelines into postoperative care workflows at 4 pre-determined timepoints. A modified Delphi process will be used to ensure an expert consensus on the algorithmic guideline content is achieved through a rigorous and consensus-driven process. Two rounds of structured online voting will be conducted to rate and refine each algorithmic guideline component.

Key feasibility outcomes include recruitment and retention rates, surgeon adherence, data completeness, and integration into routine workflows. Preliminary effectiveness will be measured using patient-reported outcomes, timeliness of referral to supportive providers and resources, use of supportive services, rates of surgical regret, and measures of functional recovery.

• Algorithmic Guideline for Functional Recovery following Cancer Surgery (Behavioral): This is a pilot feasibility study to test the clinical use of a novel algorithmic guideline to support patient functional recovery following cancer surgery. To date, no algorithmic guideline exists to support functional recovery as a primary postoperative outcome.

Primary outcomes

• Rate of Surgeon Utilization of the Algorithmic Guidelines for Functional Recovery following Cancer Surgery [6 months]: The primary outcome is surgeon use of the novel guideline to guide the postoperative clinical care of patients recovering from GI cancer surgery. This will be measured by in-clinic fidelity monitoring, i.e. researcher monitoring of clinical use of the developed guideline.

Sex: All, ages: 18 Years to any

Inclusion Criteria:

* Surgeons who perform abdominal surgery for cancer at the study institution

Exclusion Criteria:

* Surgeons who do not perform abdominal surgery for cancer
* Surgeons who are external to the study institution

• Kimberly E Kopecky, MD,MSCI, Principal investigator, University of Alabama at Birmingham