A simple method to secure data-driven improvement of perioperative care
Enhanced recovery after surgery (ERAS) programmes have been adopted to a varying degree by most surgical departments, not only in Denmark, but worldwide.
To report the process from a local ERAS unit in a tertiary university hospital to accelerate implementation of ERAS programmes in all surgical specialties.
All surgical departments receive twice-yearly procedure-specific data on length of stay (LOS), readmission rates and death within 30 days, based on surgical codes and the Danish National Patient Register. The ERAS unit and clinical experts review data followed by a clinical audit where appropriate.
Setting up data presentation for clinical and nurse leaders has documented progress in implementing ERAS. The combination of outcome data, together with audits have been essential.
The local ERAS unit has been shown to accelerate implementation of ERAS programmes in all surgical specialties, facilitated by procedure-specific LOS and re-admission data, combined with audit data.
Enhanced recovery after surgery (ERAS) programmes aim to achieve early recovery after surgery. The concept focuses on optimising all the important perioperative components, such as optimised patient information, anaesthesia, pain and fluid therapy and minimally invasive surgery, together with updated care principles, such as the use of drains, catheters, fasting rules, early mobilisation and nutrition (Kehlet and Wilmore, 2008). ERAS is a multidisciplinary concept in which nursing has a major and decisive impact, as the quality of perioperative care is essential to improve the postoperative outcome. Thus, it is crucial that nurses understand their role and the background and impact of ERAS programmes (Balfour et al, 2019).
Enhanced recovery programmes have been described in all surgical specialties based on procedure-specific, evidence-based clinical guidelines, showing benefits such as faster recovery and reduced length of stay, without increased risk of readmission, fewer medical complications (cardiovascular, pulmonary and thromboembolic), less fatigue and faster resumption of normal daily activities after discharge, as well as reduced costs (Kehlet and Jørgensen, 2016; Ljungqvist et al, 2017).
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