ERAS represents a paradigm shift in how patient care is planned, delivered and monitored. It is its multidisciplinary team approach that has allowed such success in improving patient experience, reducing length of stay, decreasing complication rates and hospital readmissions. These clinical gains are obtained at the same time as the cost of care is reduced. ERAS is a proven example of value-based medicine.
Tracy Wasylak, Senior Program Officer, Strategic Clinical Networks with Alberta Health Services, testimonial:
"Learning Health Systems use evidence and data to improve clinical outcomes and system performance. Programs like Enhanced Recovery After Surgery introduce those practices that reduce harm and improve outcomes for patients. Having robust guidelines, coupled with responsive data and feedback systems allow clinicians and teams to monitor their progress, better understand how their practice impacts patients and enhances teamwork.
While ERAS programs are recognized as an excellent tool for clinicians, they also are an excellent program for Health System Leaders to be able to monitor effectively surgery program performance from a quadruple aim perspective. Effective leadership requires responsive evidence-based pathways and data to drive value in health care from a patient, provider, population and value for money perspective. By adopting a province wide ERAS program for Alberta, we are driving improvement and improving outcomes for all."
"Free from Harm: Accelerating Patient Safety Improvement Fifteen Years after To Err Is Human" National Patient Safety Foundation is an assessment of the state of the patient safety field in 2015 and set eight recommendations to further improve quality of care:
- Ensure that leaders establish and sustain a safety culture
- Create centralized and coordinated oversight of patient safety
- Create a common set of safety metrics that reflect meaningful outcomes
- Increase funding for research in patient safety and implementation science
- Address safety across the entire care continuum
- Support the health care workforce
- Partner with patients and families for the safest care
- Ensure that technology is safe and optimized to improve patient safety
ERC Meets the Quadruple Aim
View A Guide to Patient Safety Improvement
A Resource for Healthcare Providers
click here to access the Enhanced Recovery Canada™ (ERC) Colorectal Pathways. These pathways follow the patient experience from pre-admission to post discharge and have been built on six core pillars: Patient/Family Engagement, Nutrition Management, Perioperative Fluid and Hydration Management, Perioperative Early Mobility and Physical Activity, Surgical Best Practices and Multimodal Opioid-sparing Analgesia.
This resource also includes a template for physician orders as well as a data collection and measurement resource, both of which are aligned with the ERC Pathways.
Dr. Henrik Kehlet is perhaps the most well-known surgeon among anesthesiologists around the world due to his substantial contributions toward the understanding of surgical pathophysiology. After a natural evolution from his studies on the surgical stress response, Dr. Kehlet launched in the mid-1990s the concept of "fast-track surgery": a multimodal, evidence-based approach to surgical care. Through a series of prospective cohort studies and randomized controlled trials initially using the model of colonic surgery, Dr. Kehlet demonstrated that modifying the perioperative surgical stress response and revising traditional surgical care could have a dramatic impact on postoperative recovery and shorten the length of hospital stay.
Interview with Dr. Henrik Kehlet