# REST-PSLL: Re-engineering Surgical Recovery and Transitions Using Technology Patient Safety Learning Laboratory

> **NIH AHRQ R18** · UNIVERSITY OF MINNESOTA · 2024 · $499,999

## Abstract

PROJECT SUMMARY/ABSTRACT:
Emergency general surgery (EGS) - accounting for 11% of US hospital admissions; over 50% of operative
mortality; the highest risk, acuity, rate of complications, and cost in general surgery - particularly the subset of
emergency laparotomy (EL) patients which suffer the worst EGS outcomes - is increasingly recognized as a
public health crisis. While enhanced recovery programs (ERPs) have dramatically advanced pre-, intra-, and
inpatient postoperative evidenced-based best practices (EBPs), ERPs have largely ignored subsequent
postoperative home-based recovery. Despite certain postoperative complications occurring commonly after
discharge (notably over 40% of surgical site infections [SSI]), recovery for surgical patients once discharged to
home remains understudied and ripe for improvement and innovation, especially as surgical care models
increasingly shift greater proportions of postoperative recovery into the home-based setting. Digital solutions
for remote monitoring, patient engagement/education, and surgical prediction show promise but are used
minimally for surgical recovery. We hypothesize that well-designed technology solutions for EL home- and
transition-based workflows engaging diverse stakeholders will empower EL patients, their caregivers, and care
teams to achieve optimal outcomes and safe recovery. The goal of REST-PSLL (Re-engineering Surgical
Recovery and Transitions Using Technology Patient Safety Learning Laboratory) is to apply systems
engineering approaches to co-produce innovative and scalable patient- and care team-centric solutions for EL
home-based recovery. REST-PSLL has the following specific aims. Aim 1: Identify barriers and facilitators to
ideal at-home recovery for patients following EL. We will engage stakeholders using the Systems Engineering
for Patient Safety (SEIPS) model to identify and evaluate factors to understand barriers and facilitators of
optimal care and postoperative complications with a focus on SSI. Aim 2: Iteratively design and develop new
processes, tools, and technologies that help remove or reduce barriers to ideal at-home recovery. We will use
swimlane diagrams to then analyze for areas of improvement to generate initial design requirements and
prototypes for tools/technologies followed by iterative user-centered design to specify design requirements,
develop solutions, and conduct end-user testing at our clinical sites. Aim 3: Implement and evaluate solutions
in practice. Perform pilot testing and implementation, assess primary (addressing or avoiding trigger/potential
issue, solution us) and secondary outcomes guided by RE-AIM framework; evaluate implementation phases
guided by EPIS implementation framework to generate implementation learnings and solution revision plan(s).
REST-PSLL is poised to be highly successful and impactful, highlighted by: a) anticipated learnings that can be
extrapolated to other surgical populations; b) use of transdisciplinary complementary...

## Key facts

- **NIH application ID:** 10913467
- **Project number:** 5R18HS029616-02
- **Recipient organization:** UNIVERSITY OF MINNESOTA
- **Principal Investigator:** Jenna Louise Marquard
- **Activity code:** R18 (R01, R21, SBIR, etc.)
- **Funding institute:** AHRQ
- **Fiscal year:** 2024
- **Award amount:** $499,999
- **Award type:** 5
- **Project period:** 2023-09-01 → 2027-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10913467

## Citation

> US National Institutes of Health, RePORTER application 10913467, REST-PSLL: Re-engineering Surgical Recovery and Transitions Using Technology Patient Safety Learning Laboratory (5R18HS029616-02). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10913467. Licensed CC0.

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