Reducing LOS

San Diego—Implementation of enhanced recovery after surgery (ERAS) protocols for pancreatic surgery decreased hospital length of stay (LOS), a study concluded, which ultimately improves quality of care, accelerates recovery, improves outcomes and optimizes utilization of health care resources.

“Enhanced recovery clinical pathways are really a paradigm shift that serve to evaluate our traditional practices and make evidence-based recommendations for improvement,” said Lavinia M. Kolarczyk, MD, assistant professor of anesthesiology at The University of North Carolina at Chapel Hill School of Medicine. “Nevertheless, the pathways themselves are not novel. The innovative aspect of enhanced recovery is learning how to work together in multidisciplinary teams to implement these best-practice guidelines.

“Ultimately, ERAS serves as the vehicle to promote quality improvement research; break down practice silos between anesthesiologists, surgeons and perioperative nurses; and really challenge why we do what we do every day.”

Goals of ERAS

Given that previous studies have shown a beneficial effect of ERAS pathways on hospital LOS after pancreatic surgery, the investigators decided to follow suit using a multidisciplinary approach with stakeholders from the Departments of Anesthesiology, Surgical Oncology and Perioperative Nursing. “Our institution is a very busy pancreatic center, but prior to ERAS, the quality of care was inconsistent,” Dr. Kolarczyk said. “This was unacceptable for a patient population at highest risk for perioperative morbidity and mortality.”

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