Overview of Enhanced Recovery After Surgery: The Evolution and Adoption of Enhanced Recovery After Surgery in North America.

Enhanced Recovery is broadly defined as the application of evidence based perioperative care elements for improved surgical outcomes. Demonstration of decreasing surgical stress with innovation of surgical technique, in combination with pressure to drive down health care costs, have coalesced into a unique version of perioperative medicine in the United States. The US government has failed to show interest; there are no performance metrics, no participation requirements, and certainly no monetary incentives for implementation of best perioperative practices. When considering the term, Enhanced Recovery is, in its broadest sense, an amalgam of industry, innovation, patient-focused care, cost-effective strategies, and collaboration with a goal of best perioperative outcomes.