The implementation of Enhanced Recovery After Surgery (ERAS) protocols is in full swing at UVA Health System. Originally introduced as a trial for patients undergoing elective colorectal surgery, the program is now being adopted for thoracic and gynecologic surgery, with hepatobiliary and orthopedic surgery next in line. “We are expanding ERAS protocols as quickly as we can because there’s proven value in it,” says UVA anesthesiologist and program champion Robert Thiele, MD.
Early study results for colorectal surgery patients showed positive improvements in length of stay, complication rates, patient satisfaction and cost savings. Yet, every surgical population is different, says Thiele. “This program puts nurses, anesthesiologists and surgeons together to come up with a protocolized care pathway that works for their patients,” he says. “The philosophy is applicable to every patient population. Some benefit more than others.”
According to obstetric and gynecologic anesthesiologist Mohamed Tiouririne, MD, ERAS has changed gynecologic surgery at UVA for the better. The use of non-opioid pain medicine to control pain, allowing patients to have carbohydrate drinks closer to the time of surgery and encouraging patients to walk soon after their procedure are key elements of ERAS that Tiouririne believes have helped hasten recovery. But he says the most impactful element of ERAS has been the systematic education and preparation that is provided to patients prior to surgery.
“We now educate patients about each step of their upcoming procedure from the time the surgery is announced to the time of discharge from the hospital,” he says. “In other words, patients are no longer passive participants, but take charge of their own care.”
As UVA continues to introduce ERAS into other surgical subspecialties, Thiele is reaching out to providers across the country to share the benefits of ERAS and the implementation strategies that have been most effective at UVA. “Because we work at a teaching hospital affiliated with a public university, part of our job as UVA physicians is to ensure that advances in care that originate in academic medical centers make their way into community practices, where they can be even more impactful. So we spend a lot of time helping both academic and community medical centers develop their own ERAS protocols, and view this as fundamental to our mission as a teaching institution.”
If you would like to discuss the development of an ERAS program at your institution with Dr. Thiele and his surgical colleagues, please contact our Physician Relations team.