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Finding Useful Techniques to Upgrade Recovery Enhancement

FUTURE is an MBSC quality improvement initiative aimed at evaluating evidence-based care improvement processes as part of a multimodal perioperative care pathway. September 2019 marked the beginning of the 6-9-month evaluation period of the FUTURE protocol guidelines at our 5 pilot sites.

Image by Brandon Holmes


  • Study began in February 2019 and has been extended through October 2020 due to the current health crisis. 

  • The study began with an initial 3-month baseline period in February 2019, which involved evaluating pre-implementation outcomes measures through baseline data collection and the onboarding of surgical teams and other departments.

  • 3 control sites also collected baseline data for the initiative during this time.


  • Throughout the summer of 2019, sites rolled out the protocol guidelines. Sites did ongoing troubleshooting and training within in their programs and hospitals.

  • The coordinating center also performed site visits at the pilot sites to observe and discuss their processes. Barriers were revealed and collaborative solutions were identified.

  • Team conference calls and site visits informed changes to the guidelines and they were modified and adapted as necessary. Sites have been using the guidelines and monitoring outcome measures over the past 6-9 months. 


  • In late 2019 and early 2020, we worked with the pilot sites to complete 5 random chart audits to learn more about the implementation of FUTURE at each pilot site.

  • We reviewed our findings during our February tri-annual meeting comparing findings across our 5 pilot sites. Our goal was to provide each pilot site with a clearer understanding of how the protocol guidelines were being implemented and highlight any areas that need improvement.  


  • Over the spring and summer of 2020, we worked to complete qualitative interviews with each of our pilot sites and their team. Our goal was to learn from each team to determine best practices in implementing the FUTURE initiative and provide recommendations to other hospitals interested in participating.

  • The next steps of the FUTURE initiative include rolling the program out to a subset of our hospitals in early 2021.

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