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Enhanced Recovery After Surgery (ERAS)
Surgery SCN


What is ERAS?

Enhanced Recovery After Surgery (ERAS) standardizes care before, during and after surgery. ERAS helps patients get back on their feet quicker while shortening hospital stays and reducing surgical complications. The implementation of ERAS in Alberta is sponsored by the Surgery Strategic Clinical Network (Surgery SCN™).

Each year, more than 280,000 surgeries are performed across Alberta at 55 surgical sites. The Surgery SCN is dedicated to making surgical care in our province efficient and sustainable.

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.

Quick Reference

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What is ERASAlberta?

What is ERASAlberta?

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.

Benefits of ERAS in Alberta

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 implementation 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.

In 2016, Rockyview General Hospital, Red Deer Regional Hospital Centre and Chinook Regional Hospital became approved ERAS implementation sites, allowing more Albertans to benefit from this innovative approach to surgical care. Large urban hospitals, like Foothills Medical Centre, Royal Alexandra Hospital and the University of Alberta Hospital, along with the Rockyview General Hospital and the Misericordia Community Hospital, are currently implementing multiple ERAS guidelines.

The Surgery SCN is the sponsor for the ERASAlberta initiative. Implementation research partners include Alberta Innovates and Canadian Institutes for Health Research (CIHR).

Watch:  Benefits of the Enhanced Recovery After Surgery (ERAS) Project (AHSChannel – YouTube)

Meet the Team

Who is involved in ERASAlberta?

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.

ERASAlberta Physician Co-Leads

  • Dr. Gregg Nelson
  • Dr. Leah Gramlich

Leadership Team

Senior Medical Director, Surgery SCN

  • Dr. Jonathan White

Senior Provincial Director, Surgery and Bone & Joint Health SCNs

  • Jill Robert

Executive Director, Surgery SCN

  • Stacey Litvinchuk

Provincial Manager, ERASAlberta

  • Alison Nelson

Research Lead, ERASAlberta

  • Dr. Loreen Gilmour

Provincial Coordination Team, ERASAlberta

  • Allison Marchuk, ERAS Nurse Instructor, PLC
  • Christine Fantuz, ERAS Nurse Instructor, RGH
  • Christine Garland, ERAS Nurse Instructor, FMC
  • Danielle Stevenson, ERAS Nurse Instructor, RAH
  • Jana Moore, Project Manager, Provincial
  • Janine Kuester, ERAS Nurse Instructor, MCH
  • Jennifer Kletke, ERAS Nurse Instructor, RDRHC
  • Jody Bielesch, ERAS Nurse Instructor, FMC
  • Karen Jaretzke, ERAS Nurse Instructor, RAH
  • Kate Vogelaar, ERAS Nurse Instructor, UAH
  • Katrina Percival, ERAS Research Nurse, Provincial
  • Kevin Iwaasa, ERAS Nurse Instructor, CRH
  • Lynn Nicholson, Project Manager, Provincial
  • Maria Linehan, Project Manager, Provincial
  • Melissa Smokeyday, Senior Analyst, Provincial
  • Miranda Klein, ERAS Nurse Instructor, UAH
  • Nancy Walter, Project Manager, Provincial
  • Pat Trudeau, ERAS Nurse Instructor, FMC
  • Patricia Magtalas, Administrative Support, Provincial
  • Sadhana Kalyankar, Clinical Data Coordinator, Provincial                                                                              
  • Shawna Kunyk, ERAS Nurse Instructor, UAH
  • Shandra Harman, Senior Project Manager, Provincial
  • Tanya Kuntz, ERAS Nurse Instructor, GNCH
ERAS in Alberta

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 implementation of ERAS has expanded to include seven other major surgical sites in Alberta.

Resources, Training, Research

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 clinicians, care providers and patients.

ERAS Patient Education Resources

Online Resources

Your Surgery Journey - Patient Guide (MyHealth.Alberta.ca)

Your Surgery Journey - Video Series (MyHealth.Alberta.ca)

Eating and Drinking Before Surgery: Patient Instructions (MyHealth.Alberta.ca)

Improving Surgery By Talking To Each Other | Olle Ljungqvist | TEDxBeaconStreet>

Print Resources

Health care providers can order the following resources online, by accessing Data Group Online Catalogue and placing an order using the product numbers provided below.

  • On the Road to your Recovery: A Patient’s Guide to ERAS (104898)
  • ERAS Your Bowel (104916)
  • ERAS Your Liver (104917)
  • ERAS Your Pancreas (104920)
  • Your Surgery Journey - Video Series Handout (DE-1058)

ERAS Provider Education Resources

Research      

ERAS Guidelines are evidence-based and have been tested world-wide. There are many articles and other research available for a deeper understanding of the ERAS way of providing care.

ERAS Around the World