Eastern Health is one of four Regional Health Authorities in Newfoundland and Labrador, servicing approximately 300,000 of the 500,000 residents of the province. We perform more than 24,000 inpatient surgeries annually across five surgical sites. In the provincial capital, St. John's, we have two tertiary care sites – St. Clare's Mercy Hospital and the Health Sciences Centre.
Eastern Health initiated their first Enhanced Recovery Pathway in Colorectal Surgery in 2016 at St. Clare's Mercy Hospital. Since that time we've implemented additional pathways at the same site for Lung Lobectomy, Joint Arthroplasty, and Head & Neck Surgery (Free Flap Reconstruction). In 2018, our upcoming Enhanced Recovery Pathways will include Vascular Surgery (Lower Limb Bypass), followed by expansion to the Health Sciences Centre with implementation of Cardiac Surgery (Coronary Artery Bypass Graft).
In 2016 and 2017 we gained experience in developing interdisciplinary teams, engaging physician groups, creating standardized order sets and clinical pathways, redesigning patient education material, data collection and analysis through NSQIP (National Surgical Quality Improvement Program). We introduced many clinical practice changes along the entire surgical continuum and subsequently recognized improvements in patient outcomes. We have significant experience in Change Management and recognize the value in engaging front-line staff and clinical leaders to achieve success. Considering the size of our organization and the number of surgeries performed annually, our experience may relate closely with provinces of a similar size or institutions who are interested in implementing similar pathways.
The Enhanced Recovery Program, as part of the Central Intake Division for Surgical Services, exemplifies our organizational commitment to continuous Quality Improvement. Central Intake implements quality programs and evidenced-based practice to systematically improve the way we deliver service and care to our patients. Beyond implementation, we are committed to sustainability. Improvement that is measureable and meaningful for those who are closest to our patients, where front line leaders can initiate cycles of continuous improvement, to build a culture of enhanced quality and safety for everyone.
Dr. Jeremy Pridham
Dr. Chris Smith