Enhanced Recovery After Surgery (ERAS) standardizes care before, during and after surgery, in order to get patients back on their feet quicker while shortening hospital stays and reducing complications after surgery. This initiative is sponsored by the Surgery Strategic Clinical Network (SSCN).
Each year, more than 230,000 surgeries are performed across Alberta at 59 Alberta Health Services (AHS) sites. The Surgery SCN believes surgical care can be delivered quicker, safer and smarter in all areas of the province.
Drawing from best practices and evidence from around the world, ERAS improves patient care related to nutrition, mobility after surgery, fluid management, anesthesia and pain control. ERAS also makes patients part of the team by involving them in preparation for their surgery and post-operative recovery. It aims to help patients stay strong, improve outcomes, reduce complications and create a better patient experience.
ERASAlberta brings physicians and clinical care teams together to implement ERAS international guidelines at local sites. Each guideline specifies protocols for patient care to be used for an elective surgery. For example; Colorectal surgery, Pancreas surgery and Cystectomy surgery have international guidelines that are being followed at some sites in Alberta. This involves changes to surgical practices, nursing care and quality improvements that benefit patients.
After major surgery, ERAS colorectal patients in Alberta were found to experience less major surgical, lung, and heart problems, with better outcomes and savings to the healthcare system. The six original sites in Edmonton and Calgary have shown ERAS colorectal patients are discharged up to an average of 2.3 days sooner than non-ERAS patients. Between 2013 and 2015, ERAS colorectal implementation demonstrated conservative realized net savings of $3.6 million; a gain four times greater than the implementation investment.
Through the PRIHS (Partnerships for Research and Innovation in the Health System), the Surgery SCN has expanded the initiative to other parts of the province (Red Deer and Lethbridge). For more information about PRIHS see Alberta Innovates Health Solutions.
Each ERAS site team is led by a surgeon, an anesthesiologist and an operations leader along with a dedicated ERAS Nurse Coordinator(s) experienced in clinical engagement, clinical data and quality improvement. The ERAS Site teams are connected through the ERASAlberta provincial coordination team.
The ERASAlberta work is lead and guided by a provincial implementation lead, an integrated research lead, and medicine and surgeon co-leads. The Surgery Strategic Clinical Network (SSCN) provides ERASAlberta with access to executive leadership, advanced clinical data analysis, research opportunities and knowledge translation.
Senior Provincial Director
Provincial Coordination Team
A test of elective colorectal ERAS began at Calgary’s Peter Lougheed Centre (PLC) and Edmonton’s Grey Nuns Community Hospital in 2013. Since then the project has expanded to include seven other major surgical sites in Alberta. ERAS Guidelines now also include Gynecological, Cystectomy, Liver, and Pancreas surgeries. In 2016/2018, some of the sites will become multi-guideline champions of ERAS:
ERAS represents some changes to surgical practices and nursing care. It also places the patient first and makes each person an active participant in the outcomes. Increasing knowledge and gaining new skills are key factors in making changes that will become routine for medical staff and patients.
ERAS Guidelines are evidence-based and tested world-wide. There are many articles and other research available for a deeper understanding of this new way of doing things.