Improving Surgical Care and Recovery

Background

Enhanced Recovery Pathways (ERPs) are a proven means of minimizing the physiological trauma of surgery to reliably shorten length of stay, decrease complications and costs, and improve patient experience. Institutions have used ERP programs to decrease length of stay by 1-2 days per patient, decrease complication rates by approximately 50%, save over $6,000 per patient, decrease 30-day re-admission rates by over 40%, and improve patient satisfaction scores.

ERP is accomplished by focusing on better education and management of patient expectations, minimization of fasting before and after surgery, minimizing opioids in lieu of opioid sparing pain medications, minimizing IV fluids, and promoting early and frequent ambulation and convalescence.

Implementing these changes to the way care is given requires transdisciplinary teamwork and buy-in. All providers and patients need to speak the same language to optimally implement ERP.

About the Project

The Agency for Healthcare Research and Quality (AHRQ) is funding and guiding a national quality improvement initiative titled Improving Surgical Care and Recovery (ISCR). The program is a collaborative effort between the Johns Hopkins Armstrong Institute, the American College of Surgeons (ACS), and AHRQ to enhance the recovery of surgical patients by supporting hospitals in implementing perioperative evidence-based pathways to meaningfully improve clinical outcomes, reduce hospital length of stay, and improve the patient experience.

ISQIC has built on the ISCR initiative by strengthening hospitals’ readiness to implement Enhanced Recovery Pathways (ERPs) and providing additional implementation support and resources. ISQIC hospitals are completing a two-part self-diagnostic tool to assist them in identifying areas where the implementation core team and departments impacted by the pathway can be strengthened. The ISQIC Readiness Assessment Toolkit then provides tools to build and strengthen the areas identified in the assessment.