Reduce opioids, improve outcomes: Insights into Cooper University Hospital's ERAS program

A lack of standardization in perioperative care can negatively affect patient outcomes and increase costs for hospitals. Enhanced recovery after surgery protocols can help standardize surgical procedures to ensure patients receive high-quality care and providers efficiently manage costs. 

ERAS protocols cover every step of the perioperative process, from the moment a physician decides a patient needs surgery until the patient is at home and recovered. During a June 11 webinar sponsored by Mallinckrodt and hosted by Becker's Hospital Review, Ron Desai, DO, director of division regional anesthesia and director of rotating/visiting residents at Cooper University Hospital in Camden, N.J., discussed ERAS and how the protocols can benefit both patients and providers. 

Five key takeaways: 

  1. ERAS protocols are evidence-based guidelines to standardize perioperative care with the goal of improving patient outcomes. ERAS protocols are designed to reduce patients' stress response to surgery and involve providers from all departments (nurses, surgeons, anesthesiologists, etc.) coming together to discuss how to improve care for patients.

  2. ERAS can save hospitals money in addition to improving patient outcomes. In a study cited by Dr. Desai, researchers found that using ERAS protocols lowered costs for colorectal procedures by about 10 percent per patient compared to using standard protocols and shortened the average overall patient length of stay by 2.5 days, which reduces the strain on hospital costs.

  3. Educating patients about their procedure beforehand is essential to improving their outcome. Only 63 percent of patients receive education on pain management before surgery, according to a study cited by Dr. Desai, though it's one of patients' top concerns. Pre-admission counseling lets providers manage expectations for patients when it comes to their pain levels. Providers should ensure they are giving patients clear, easy-to-understand information about their procedure and about pain management before the surgery takes place, Dr. Desai said.

  4. Multimodal analgesia is a key factor in ERAS protocols as it lessens opioid-related adverse events and shortens patients' overall length of stay. Multimodal analgesia uses various medications for pain relief to limit opioid reliance. Opioid-related side effects are a major patient concern that can also lead to longer overall length of stays for patients, which drains hospital resources, Dr. Desai said. More than 70 million patients undergo surgical procedures every year and 80 percent experience postoperative pain, so managing that pain properly is a key component of improving overall patient outcomes.

  5. To implement ERAS protocols, start by creating a team of providers from different departments, including anesthesia, surgery, nursing and administrative, who can work together to ensure all departments follow appropriate protocols. Make sure to hold regular meetings across departments.

    Target surgeries with long length-of-stays and high complication rates, such as colorectal surgeries, cystectomy and spinal surgeries, for which ERAS protocol will have the greatest impact. Make checklists available to providers from every department to ensure they follow each protocol. 

To watch the full webinar, click here

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