"Enhanced Recovery After Surgery - ERAS is a program highlighting surgical best practices and consists of a number of evidence-based principles that support better outcomes for surgical patients including: an improved patient experience, reduced length of stay, decreased complication rates and fewer hospital readmissions."
A recent article drew my attention to this emerging trend. Most people get anxious at the thought of getting surgery, even more so, about the recuperation period where they are required to stay in a hospital under observation. A new program called "Enhanced Recovery Canada" is leading the drive to improve surgical safety across the country and help disseminate these ERAS principles.
The goal of the program is to make people stronger before they go in for surgery physically, mentally and emotionally, through education, exercise, nutrition, and lifestyle modifications. Taking these steps reduces risk factors when people go in for surgery, and makes the recovery process faster and easier.
Some of the steps taken prior to surgery involve optimizing the body's functioning capacity. For example, smoking and alcohol intake is prohibited 4 weeks prior to surgery. HRT (Hormone Replacement Therapy) and OCP (Oral Contraceptive Pills) are stopped. Patients receive peri-operative counselling services, and nutritional advice. Anemia is investigated and treated.
At the time of surgery, great care is taken to administer appropriate antibiotics, and maintain the body's temperature and hydration level along with vitals like HR (Heart Rate), BP (Blood Pressure), and RR (Respiration Rate).
After the surgical procedure, patients are encouraged to get back on their feet and intake of solid food is recommended as soon as possible. Preventive treatment against venous thromboembolism and multimodal pain management is administered. Supportive therapy like urinary catheters, nasogastric suction and intra-abdominal drains are avoided to help the body spring back to action.
"Because the ERAS approach begins before admission for surgery and continues postoperatively, a multidisciplinary team of health care professionals must coordinate the approach to ensure the successful implementation of a protocol. Implementation of an ERAS protocol can be challenging; however, there are clear advantages for patients and potential savings for the health care system." say a group of authors who reviewed the ERAS program.
If you or a loved one have been scheduled for surgery, feel free to connect with an experienced ERAS coordinator here. I trust you will find this 6 part interview with international ERAS expert Dr. Henrik Kehlet to be interesting and informative.
If you have any questions about the ERAS program, feel free to connect with me or leave a comment.
Nikita
Healthcare Consultant, in4MED
Sources:
1. www.patientsafetyinstitute.ca
2. CBC News - McGill program helps patients prep for surgery and get back on their feet faster. Feb16, 2019.
https://www.cbc.ca/news/canada/montreal/peri-operative-program-montreal-general-1.5022640
3. Enhanced recovery after surgery: implementing a new standard of surgical care http://www.cmaj.ca/content/191/17/E469
4. Enhanced Recovery After Surgery (ERAS) program attenuates stress and accelerates recovery in patients after radical resection for colorectal cancer: a prospective randomized controlled trial. https://www.ncbi.nlm.nih.gov/pubmed/22102090
The author of this blog post is a Physician with over 10 years of experience working in the healthcare system as a clinician, researcher and educator. She is passionate about healthcare for older adults and strives to be a resourceful inspiration to caregivers.
*No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified healthcare professional.
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