Enhanced Recovery After Surgery (ERAS) protocols result in major improvements in clinical outcomes and cost, reducing length of stay up to 50%, according to a recent analysis. The researchers call ERAS a good example of value-based care applied to surgery.
(An abstract of the report is available online at: http://bit.ly/2m482KY.)
ERAS started with colorectal surgery but has been to work with almost all major surgical specialties, the researchers note. It involves a team consisting of surgeons, anesthetists, an ERAS coordinator, and staff from units that care for the surgical patient. The care protocol is based on best practices and sometimes is contrary to traditional methods of care. For instance, the protocols call for switching from an overnight fast to having the patient drink carbohydrate drinks two hours before surgery.
The protocols also require minimally invasive approaches instead of large incisions, management of fluids to seek balance rather than large volumes of intravenous fluids, avoidance of or early removal of drains and tubes, early mobilization, and serving of drinks and food the day of the operation, the study notes.
The researchers concluded that ERAS protocols have reduced length of hospital stay by 30% to 50%, with reductions in complications. Readmissions and costs also were reduced.
They also noted the importance of auditing process compliance and patient outcomes.
