Table 3.

Effectiveness and implementation outcomes

	Aim 1 - clinical effectiveness	Aim 2 - implementation
Test	ENRICH-US Intervention	Implementation strategy
Analysis	Patient- and hospital-level assessment	Surgeon- and hospital-level assessments
Theoretical outcomes	Health outcomes; process/quality measures are considered intermediate steps	Adoption/uptake of the clinical intervention; process/quality measures
Primary outcomes	Length of stay (LOS) for Aim1a	Implementation metrics including adoption, fidelity, and sustainability for Aim2a
Secondary outcomes	Decreased intra-operative fluid usea, decreased intra-operative and post-operative opioid usea, shorter time to regular dieta, health care utilization, surgical complicationsb, HRQoL assessment for Aim 2b.	Contextual factors associated with implementation including modifications and adaptations to materials, implementation barriers, implementation outcomes, and feedback on challenging ERP elements at site level for Aim2b

^aThese outcomes are specifically addressed by ERP elements and interventions

^bComplications are defined as per ACS NSQIP Pediatric definitions