July 13, 2016

Development of an anesthesia enhanced recovery pathway

Surgical enhanced recovery pathways (ERPs) comprise a multimodal perioperative care pathway (including components of surgery, anesthesiology, and nursing), using evidence-based best practices to facilitate early recovery.

This study describes the development of the anesthesiology portion of a colorectal ERP at Johns Hopkins Hospital, Baltimore. The anesthesiology portion of the ERP required the greatest paradigm shift for the ERP team.

The goals of the ERP were achieving superior analgesia, minimizing postoperative nausea and vomiting, facilitating patient recovery, and preserving perioperative immune function.

After 6 months, the ERP resulted in a 45% reduction in length of stay and patient satisfaction scores improved from the 37th percentile to the 97th percentile.

The results corroborate findings from previously published ERP studies. However, the process of implementing an ERP from an anesthesiology perspective has not been previously described, the authors say. The success of implementation may be attributed to leadership support, integration with an existing quality improvement infrastructure, and strong anesthesiology leadership.

—Wu C L, Benson A R, Hobson D B, et al. Initiating an enhanced recovery pathway program: An anesthesiology department’s perspective. Jt Comm J Qual Patient Saf. 2015;41(10):447-456.


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