Recovery is often the most challenging part of any surgical procedure.
Fortunately, the University of Minnesota Health thoracic surgery care team has implemented a new initiative designed to get patients out of the hospital and back on their feet more quickly.
The effort, which is called Enhanced Recovery After Surgery (ERAS), is a multi-faced approach that covers all stages of a surgical procedure. The innovative approach is better for the doctors and the hospital but, most importantly, it’s better for patients.
“It’s about putting the needs of the patient first—and incorporating patient care plans into defined, evidence-based pathways so they work in a more seamless fashion,” said University of Minnesota Health Thoracic Surgeon Eitan Podgaetz, MD. Podgaetz and Anesthesiologist Joyce Wahr, MD, FAHA, the director of the new Preoperative Assessment Center (PAC), spearheaded the initiative to bring the approach to UMMC.
In short, it’s about optimizing the patient for their procedure, treating pain before it occurs and creating synergy throughout the process.
To help patients have an easier recovery, care teams optimize patient nutrition plans before surgery—including a carbohydrate-rich drink before surgery. The team also utilizes non-narcotic regional pain blocks, performs minimally invasive surgeries and coordinates other post-surgical services, like occupational therapy, physical therapy and respiratory therapy. The team has also made adjustments to surgical methods and pain management techniques so procedures carry a lower risk of complications.
Before, during and after each procedure, the patient and care teams have a several hundred decisions to make regarding patient care, Podgaetz said. Streamlining the process in appropriate situations can save time, expedite recovery, increase patient satisfaction and make the decision process less burdensome in some areas.
“It’s translated into huge benefits to patients and hospitals,” Podgaetz said. “It’s a win-win situation.”
Patients are spending fewer nights in the hospital—from as many as three down to one, Podgaetz said —which frees up beds and dedicated time for other patients.
So far, Podgaetz said the thoracic surgery care teams have used this new approach with about 20 patients and the benefits have been apparent. Whereas surgical procedures have seen tremendous advancements in the past several decades, pre- and post-operative processes haven’t kept pace, Podgaetz said. This initiative changes that.
This holistic approach also helps avoid errors in the hand-off between primary care physicians who refer patients to University of Minnesota Medical Center and the transition from the medical center back to a referring physician.
“We’ve been able to send patients home the next day with minimal pain and medicine,” Podgaetz said. “We’ve been extremely happy. We’re still learning all the benefits.”