Overview: TKO

Created: July 24, 2024

Contributor: ERAS Cardiac TKO Writing Group

Editor: ERAS Cardiac TKO Writing Group

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Summary

A frequently identified barrier to successful the ERAS Cardiac implementation is the challenge of integrating existing evidence into clinical application at the bedside. To facilitate the synthesis of scientific knowledge into patient care, ERAS Cardiac is developing Turnkey Order Sets (TKO) for a variety of enhanced recovery elements.

Turnkey Order Set (TKO) Methodology

Members of the ERAS Cardiac TKO Writing Group have reviewed the literature on each element, prioritizing existing evidence-based Guidelines, Practice Advisories, and Consensus Documents from a variety of medical societies and organizations. Additional high-quality literature, including review articles, systematic reviews, and large prospective trials have also been included where appropriate.

The recommendations from these sources has then been translated by perioperative subject matter experts into TKOs, using accumulated evidence, peer-reviewed literature, and current enhanced recovery practices.

Orders derived from Class I or IIA recommendations across all referenced guidelines and consensus manuscripts appear in the TKO in bold type.

Selected orders that were inconsistently Class I or IIA, Class IIB, or supported by evidence published in peer-reviewed journals, were also included in italicized type.

Decisions regarding order inclusion were made based on estimated benefit, risk, cost, implementation complexity, and generalizability. Each of these orders should be considered based on local institutional priorities, resources, practices, and expertise.

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