Stone Alexander B, Grant Michael C, Wu Christopher L, Wick Elizabeth C
Department of Anesthesiology, Brigham and Womens Hospital, Boston, Massachusetts.
Department of Anesthesiology/Critical Care Medicine, The Johns Hopkins Medical Institutions, Baltimore, Maryland.
Clin Colon Rectal Surg. 2019 Mar;32(2):129-133. doi: 10.1055/s-0038-1676478. Epub 2019 Feb 28.
Enhanced Recovery After Surgery (ERAS) programs are transdisciplinary, evidence-based perioperative protocols that aim to standardize best practices and increase the value of delivered healthcare. Quality improvement programs such as ERAS for colorectal surgery have been linked to a reduction in rates of hospital-acquired infections (HAIs) including surgical site infection as well as a reduction in overall length of stay. Importantly, to achieve these results, hospitals must commit to fostering transdisciplinary collaboration across surgery, anesthesiology, and nursing, as well as alignment between frontline providers and hospital executives. This requires upfront investment as well as ongoing resource allocation to sustain the program but given the magnitude of the potential impact of a successful ERAS program on multiple domains of quality and safety, the investment will easily reap ongoing rewards. The purpose of this manuscript is to outline implementation and sustainability costs of an ERAS program as well as discuss the potential cost savings related to the program to further inform hospitals considering adoption of this approach to care.
术后加速康复(ERAS)计划是跨学科的、基于证据的围手术期方案,旨在规范最佳实践并提高所提供医疗服务的价值。诸如结直肠手术的ERAS等质量改进计划与降低包括手术部位感染在内的医院获得性感染(HAIs)发生率以及缩短总体住院时间有关。重要的是,为了取得这些成果,医院必须致力于促进外科、麻醉和护理之间的跨学科合作,以及一线医护人员与医院管理人员之间的协调一致。这需要前期投资以及持续的资源分配来维持该计划,但鉴于成功的ERAS计划对质量和安全的多个领域可能产生的巨大影响,这种投资将很容易获得持续回报。本手稿的目的是概述ERAS计划的实施和可持续性成本,并讨论与该计划相关的潜在成本节约,以便为考虑采用这种护理方法的医院提供更多信息。