Many
hospitals have transitioned to the Enhanced Recovery After Surgery (ERAS)
program. With this program, patients are involved in their care before, during and after surgery. It seems like a simple concept, but it’s making a
difference: ERAS patients are typically able to return home two days sooner and are less
likely to be readmitted due to complications.
Colleen Effa, ERAS Nurse Co-ordinator at the Misericordia Community Hospital, describes the program and its benefits.
What does ERAS stand for?
Colleen: ERAS stands for Enhanced Recovery After Surgery. It started as a care plan for bowel surgeries but is now moving into other surgical areas including liver, cystectomy, gynecology, vascular, breast reconstructions and more throughout the province.
What are the benefits of ERAS?
Colleen: ERAS is a program that helps patients recover and return to regular daily activities sooner and minimizes the risk of serious complications. The program also promotes patient involvement in their care.
Thanks to ERAS, patients are able to eat and move sooner after surgery.
How can patients get ready for surgery months, weeks, days or hours beforehand?
Colleen: We know that quitting smoking and healthy food beforehand can have a big impact after surgery, so seeking help to make these lifestyle changes is advised. Patients are encouraged to eat until eight hours before their surgery and to drink clear fluids such as juice until three hours before their surgery to prevent dehydration and a sugar low during surgery. Patients also prepare by reading the booklets and pamphlets they are given by the surgeon’s office and the pre-admission clinic and to ask questions to the nurses and doctors.
What is the patient’s role in their own recovery?
Colleen: Patients participate in their recovery by taking part in walking activities and other exercises, drinking provided protein drinks and providing feedback to their care team.
Mario Lemieux (right) was up walking one day after his surgery. He says ERAS is a good approach to help with recovery.
“A few hours after my surgery, I sat up on my own and took a couple of steps. ERAS is a good approach. I was surrounded by positive vibes in an environment where people encouraged me to get moving again,” says Mario Lemieux, a patient who just underwent bowel surgery.
Can you describe the surgery log book that all patients receive?
Colleen: The log book was designed to help patients track their daily goals. It helps them to know what to expect for each day and to encourage them in their role in the recovery journey.
Who is on the ERAS team?
Colleen: The team is made up of surgeons, anesthetists, dietitians, nurses, and data specialists. This team works together to ensure what is being done is in line with what evidence says is best and with what will be best for the individual patient and the patient’s priorities. We depend on each other and collaborate when we see that something can be improved.
What does ERASAlberta do?
Colleen: ERAS is a provincial initiative that is supported by the AHS Surgery Strategic Clinical Network. ERASAlberta promotes collaboration across the nine hospital sites and together looks at how surgical care can be optimized for Albertans. The team monitors the data to drive improvement for the entire system.
What are the benefits of ERASAlberta?
Colleen: We can provide more care, without compromising quality, for the same amount of money—which is good news. The program has resulted in improved patient outcomes, which has the added benefit of increasing access for Albertans to receive surgical care, because ERAS patients can recover faster and are not being readmitted for complications. This is also good news for our family, friends and neighbours who are waiting for this service.
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