Implementing ERAS: how we achieved success within an anesthesia department

Area of Science:

• Anesthesiology
• Implementation Science
• Surgical Patient Care

Background:

• Massachusetts General Hospital implemented an Enhanced Recovery After Surgery (ERAS) pathway for hysterectomy patients in March 2018.
• A 14-month intensive educational initiative was launched to implement the anesthesia bundle of this ERAS pathway.
• No further educational interventions were provided after the initial 14-month period.

Purpose of the Study:

• To evaluate adherence to the anesthesia bundle of the ERAS Hysterectomy pathway.
• To assess the sustainability of adherence after the educational intervention ceased.

Main Methods:

• Retrospective review of 2570 patients who underwent hysterectomy between October 2016 and March 2020.
• Analysis of adherence to the four elements of the anesthesia bundle.

Main Results:

• Adherence to the anesthesia bundle significantly increased during the intervention period (p < 0.001).
• High compliance with the ERAS pathway was maintained in the post-intervention period.
• The implementation science-based approach demonstrated successful adoption and sustained adherence.

Conclusions:

• Intensive educational interventions are effective for implementing anesthesia bundles within ERAS pathways.
• Successful implementation and sustained adherence can be achieved in large, diverse anesthesia groups.
• The findings support the use of implementation science for improving surgical patient care pathways.