Implementing enhanced recovery pathways to improve surgical outcomes

Shilpadevi Patil, Elyse Cornett, June Jesunathadas, Kumar G Belani, Charles Fox, Alan Kaye, Lee Lambert, Richard Urman

Research output: Contribution to journalReview article

Abstract

An enhanced recovery pathway is a structured perioperative healthcare program that incorporates evidence-based interventions including protocols and guidelines with the aim of providing standardized care. Enhanced recovery pathways can help maintain operating room safety and efficiency, improve postoperative recovery and a variety of important patient outcomes, and reduce overall costs of patient care following major surgery. Postoperative complications are minimized, which, in part, are attributed to adjustments in fasting and postoperative nutrition, interventions aimed at improving early mobilization, and careful selection of pharmacological agents for anesthesia and analgesia. Major surgery can lead to a variety of physiological stressors including organ dysfunction, and hormonal and neurological disturbances. The current notion of fast-tracking (bypassing phase I recovery level of care) differs from enhanced recovery pathways as the principles of enhanced recovery pathways are often applied to inpatient and complex procedures and span the entire spectrum of patient care. Also, enhanced recovery pathways programs are being used for pediatric patients especially with the hope of minimizing opioid exposure and the quality of recovery. A PubMed literature search was performed for articles that included the terms enhanced recovery pathways to improve surgical outcomes. In this article, we summarized the clinical application of enhanced recovery pathways and highlighted the key elements that characterize implementing an enhanced recovery pathway in surgery.

Original languageEnglish (US)
Pages (from-to)24-28
Number of pages5
JournalJournal of Anaesthesiology Clinical Pharmacology
Volume35
Issue number5
DOIs
StatePublished - Jan 1 2019

Fingerprint

Patient Care
Anesthesia and Analgesia
Social Adjustment
Early Ambulation
Operating Rooms
PubMed
Opioid Analgesics
Inpatients
Fasting
Pharmacology
Guidelines
Pediatrics
Delivery of Health Care
Safety
Costs and Cost Analysis

Keywords

  • Enhanced care
  • enhanced recovery pathway
  • intraoperative care
  • perioperative care
  • preoperative care
  • protocols
  • surgery

PubMed: MeSH publication types

  • Journal Article
  • Review

Cite this

Implementing enhanced recovery pathways to improve surgical outcomes. / Patil, Shilpadevi; Cornett, Elyse; Jesunathadas, June; Belani, Kumar G; Fox, Charles; Kaye, Alan; Lambert, Lee; Urman, Richard.

In: Journal of Anaesthesiology Clinical Pharmacology, Vol. 35, No. 5, 01.01.2019, p. 24-28.

Research output: Contribution to journalReview article

Patil, S, Cornett, E, Jesunathadas, J, Belani, KG, Fox, C, Kaye, A, Lambert, L & Urman, R 2019, 'Implementing enhanced recovery pathways to improve surgical outcomes', Journal of Anaesthesiology Clinical Pharmacology, vol. 35, no. 5, pp. 24-28. https://doi.org/10.4103/joacp.JOACP_36_18
Patil, Shilpadevi ; Cornett, Elyse ; Jesunathadas, June ; Belani, Kumar G ; Fox, Charles ; Kaye, Alan ; Lambert, Lee ; Urman, Richard. / Implementing enhanced recovery pathways to improve surgical outcomes. In: Journal of Anaesthesiology Clinical Pharmacology. 2019 ; Vol. 35, No. 5. pp. 24-28.
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