On November 10-12, 2022, Enhanced Recovery After Surgery (ERAS) leaders, advocates and practitioners gathered in Washington DC for the 5th Annual Congress of the ERAS® USA Society.
If you were unable to make it, we’ve got you covered! Today we share our five big takeaways from ERAS USA’s 2022 Annual Congress:
University Hospitals (UH) was a major player at the 2022 ERAS USA conference. Firstly, by getting certified as a Qualifying Center for Enhanced Recovery After Surgery (ERAS) in colorectal surgery - a huge milestone that less than 10 centers in the United States have achieved - congrats to our friends at UH!
Secondly, UH was highly engaged, delivering both the Day 2 keynote and multiple presentations on their success scaling ERAS to 14 pathways across 10 hospitals in just two years!
How did they achieve this so quickly? Here are eight key lessons learned shared by Dr. Heather McFarland, Co-Lead of ERAS and Vice Chair of Clinical Operations at UH:
UH has a particularly strong Cardiac ERAS program, and its Chief of Cardiac Surgery, Dr. Marc Pelletier, recently shared how his program uses a Digital Patient Engagement platform to increase ERAS compliance and reduce readmissions. Click here to watch Dr. Pelletier’s presentation on the topic.
Dr. Michael Scott, ERAS USA President, made the bold argument that ERAS is now core to delivering surgery in the post-COVID-19 era. Dr. Scott particularly highlighted the importance of patient engagement for ERAS, saying: “ERAS is even more relevant since the pandemic… patients want to be more active partners in patient care too!”
Now what happens if you take a highly successful ERAS program and supercharge it with Digital Patient Engagement technology?
Three separate examples were highlighted to answer this question…
(1) Dr. Ansley Ricker from Atrium Health answered that question in her presentation on Long-term Results from Prospectively Collected Patient-Reported Outcomes Using Mobile Health Technology in Hepatopancreatobiliary Surgery. Atrium Health is a leader in ERAS, having been the 1st designated ERAS® Society accredited Center of Excellence in the United States.
In her presentation, Dr. Ricker shared how Atrium Health partnered with SeamlessMD to provide an Epic-integrated Digital Patient Engagement platform on smartphones, tablets and computers that guided patients pre and post-surgery with ERAS reminders, education, Patient-Reported Outcome (PRO) data collection and symptom monitoring. By adding Digital Patient Engagement capabilities to their already successful Hepatobiliary ERAS program, Atrium Health was able to achieve:
To learn more about how Atrium Health uses this Digital Patient Engagement technology to achieve these outcomes, check out a recent webinar led by Misty Eller, an ERAS nurse leader at Atrium Health.
(2) As part of his ERAS Gynecology update, Dr. Gregg Nelson, ERAS Surgeon Lead for Alberta Health Services, shared research he conducted on digital collection of Patient-Reported Outcomes and Post-Discharge Remote Monitoring (e.g. wound photo monitoring). Results showed increased patient-reported scores on the Quality-of-Record (QoR) validated survey tool.
(3) Dr. Gita Mody, Director of Thoracic Surgical Oncology at UNC, presented on “Monitoring ERAS patients post-discharge”. Key ideas from Dr. Mody were:
Dr. Olle Ljungqvist, who co-founded the ERAS Society, explored how despite many organizations saying they do “ERAS”, the outcomes can be wildly different. For example, in his home country of Sweden where ERAS is supposedly the standard of care, surgical complication rates can vary 3x between the highest and lowest performing organization! Dr. Ljungqvist passionately argued that measuring and improving ERAS compliance (i.e. “audit”) is the critical difference between successful and unsuccessful ERAS programs.
So why is auditing ERAS compliance so important? Allyson Cochran, Senior Clinical Data Manager for Atrium Health, explained why ERAS compliance data drives everything:
Dr. Kevin Elias, President-Elect of ERAS USA, agreed and shared how his organization Brigham and Women’s Hospital uses “Surgeon Report Cards” to benchmark ERAS compliance data and outcomes between surgeons. Surgeons are inherently competitive, and ERAS report cards leverage that internal drive for excellence to drive better patient outcomes!
Misty Eller, Advanced Nurse Practitioner and ERAS nurse leader at Atrium Health, presented on Rapid Fire: APP & Nursing, sharing how our healthcare system is increasingly dependent on the APP workforce to deliver best-practice care models such as ERAS. In today’s challenging climate with a 70% decrease in employed nurses since 2021, Misty discussed how there’s a need to improve APP and nursing experience and satisfaction to better support the needs of health systems and patients.
However, key barriers to nurse and APP involvement with ERAS include lack of online education, monetary support and certification opportunities. To encourage more nursing and APP involvement in ERAS, Misty proposed that we need to provide more certification, scholarship, abstract contests, and research opportunities.
Supporting nurses and APP involvement with ERAS is critical to the success of this interprofessional model long-term - we certainly must find a way to do more!
Many providers realize ERAS is better for patient outcomes, but where do you start? In particular, how do you get executives bought-in?
Charlette Harte, Sr. Quality Process Improvement Consultant for ERAS, Baylor Scott & White Health, knows a thing or two about ERAS. She’s led the rollout of ERAS across a 51 hospital system!
In her presentation on Executive Engagement for ERAS, Charlotte shared four innovative strategies to get buy-in:
Doing all of these might seem daunting, however even just picking one of these to try next year is an excellent way to keep moving your ERAS program forward. Give them a shot!
ERAS is bigger than ever before and it won’t be long before it is truly the standard of care in North America. With the right technology and change management strategies, health systems can leverage ERAS to be a strategic tool to improve quality and patient safety, while also keeping staff satisfaction high.
Interested in further exploring how digital patient engagement can amplify ERAS Success, download our white paper to learn how you can leverage technology to deliver standardized ERAS patient education, improve patient compliance, decrease opioid use, and reduce high cost services like readmissions, length of stay and ED visits.