Implementation of a Successful Enhanced Recovery after Surgery Program in a Community Hospital

Area of Science:

• Surgical Care
• Hospital Management
• Anesthesiology

Background:

• Enhanced Recovery After Surgery (ERAS) protocols are proven effective in major centers.
• Community hospitals face unique challenges in ERAS implementation.
• This study details successful ERAS program creation in a community setting.

Purpose of the Study:

• To demonstrate the feasibility of establishing an ERAS program in a community hospital.
• To evaluate the impact of an anesthesiology-led ERAS program on patient outcomes.
• To highlight the role of anesthesiology in overcoming implementation barriers.

Main Methods:

• An anesthesiology-led multidisciplinary team developed an ERAS protocol for major urologic surgery.
• Quarterly reviews of clinical protocol metrics were conducted.
• Outcome data were collected via chart review and compared to pre-ERAS data retrospectively.

Main Results:

• A 37% reduction in average and median length of stay was observed post-ERAS implementation.
• A reduction in 90-day readmissions was noted.
• Statistical analysis strongly supported the ERAS protocol's impact on reduced length of stay (p<.0001).

Conclusions:

• Anesthesiology leadership is critical for successful ERAS program implementation in community hospitals.
• ERAS programs provide standardized, evidence-based care, improving patient and hospital outcomes.
• This model is adaptable to various surgical services beyond urology.