Enhanced Recovery
Enhanced Recovery is an evidence based approach to the pre-operative, intra-operative and post-operative care of patients undergoing surgery. Originally pioneered in Denmark over a decade ago it is now being championed by a growing number of health professionals in the UK.
"What does enhanced recovery have to offer patients and the NHS? In simple terms it does two things. It improves quality of care by helping patients to get better sooner after major surgery. Secondly it reduces length of stay with obvious benefits to the NHS"
Professor Sir Mike Richards
Enhanced Recovery Partnership Programme
Department of Health
Enhanced Recovery has been shown to benefit patients undergoing surgery in a range of specialities including Colorectal, Gynaecology, Orthopaedics and Urology.
Enhanced Recovery in NHSScotland
The 18 Weeks Referral to Treatment programme's Orthopaedic Task and Finish Group are sponsoring an Enhanced Recovery project that supports the implementation of evidence based clinical interventions at key stages of the primary hip and knee replacement pathways.
Enhanced Recovery was first introduced to Orthopaedics in Scotland by the Golden Jubilee National Hospital (GJNH). David McDonald is the co-ordinator of that work. Through the 18 Weeks Referral to Treatment programme, David has been supporting NHS Boards to introduce Enhanced Recovery techniques.
Many NHSScotland Boards have made significant progress. For example, within the first three months of a very successful implementation of Enhanced Recovery at NHS Borders there has been:
- a reduction in use of High Dependency Unit (HDU) beds post operative night from 100% to 0%;
- a reduction in post operative catheterisation from 100% to 10%;
- a reduction in blood transfusion rates from 40% to 5%;
- an increase in same day admission from 0% to 75%; and
- an average reduction of 4.2 days in length of stay.
Enhanced Recovery After Surgery Audit
The Scottish Government commissioned a 12-week Enhanced Recovery After Surgery (ERAS) ‘snapshot’ audit to collect data on hip arthroplasties from all Scottish operating hospitals from 4 April 2011 to 15 May 2011 and data on knee arthroplasties from 16 May 2011 to 26 June 2011.
The audit provides NHS Boards with an opportunity to benchmark their services against other Boards and to identify improvement opportunities.
Optimal patient pathways for hip and knee arthroplasties: Use of Enhanced Recovery After Surgery principles in Scotland in April-June 2011 – A one-year review of practice
Events
Delivering Timely and Efficient Orthopaedic Services: This was a one day event run by the Improvement and Support Team (IST) in partnership with the Scottish Committee for Orthopaedics and Trauma (SCOT) to consider future strategies for the development of Orthopaedics Services for the Patients of NHSScotland. It included discussion on the role of enhanced recovery and primary and community services in supporting the improvement of the orthopaedic patient journey.
Delivering Timely and Efficient Orthopaedic Services [Added 3 May 2011]
Contact
David McDonald
Senior Physiotherapist
david.mcdonald@nhs.net
Kate James
Project Manager
kate.james@scotland.gsi.gov.uk
Last updated 16 September 2011.