Enhanced Recovery protocol seeing positive results at Grand River, Valley View hospitals | PostIndependent.com

Enhanced Recovery protocol seeing positive results at Grand River, Valley View hospitals

Alex Zorn

Grand River Health's Tara Keif, RN, Dr. Steven O’Day, Medical Assistant Nichole Fuller and Julie Tamburelli-Lester, RN, coordinate patient care using Enhanced Recovery After Surgery protocols.

In the ever-evolving way doctors treat patients after surgery, teams at Garfield County’s two hospitals have begun to implement Enhanced Recovery After Surgery (ERAS) protocols to help patients recover faster and with more satisfaction.

“We have seen very encouraging results since adopting the ERAS protocol,” said Steven O’Day, general surgeon at Grand River Health in Rifle. “Specifically, we have seen a significant improvement in pain control following surgery, early mobilization, earlier return to home, and better overall experience from a patient perspective.”

The protocol has been particularly effective with colorectal surgery, he said.

“There is a significant body of data supporting the use of ERAS principles, and we are excited to offer patients the most up-to-date care for colorectal surgery at Grand River Hospital,” O’Day said.

“We are changing the culture one patient at a time.”— Tara Keif, surgical nurse at Grand River Health

According to the University of North Carolina School of Medicine, ERAS is a set of protocols used by a hospital’s surgical team to ensure a patient has the best surgery outcome, including before, during and after a procedure.

These may include increased education and pre-surgery counseling and nutritional adjustments. It can result in a return to a normal diet much sooner, among other.

Grand River Health Quality Assurance Manager Rebecca Schickling said the new program has proven to be a very beneficial recovery approach for patients undergoing colorectal surgery.

Since implementing the new program, she said excitement around it continues to build as administrators are looking at it for gynecological procedures, as well.

At Valley View Hospital in Glenwood Springs, Dr. Allison Long said the hospital is currently using ERAS for total knee replacement and will soon be implementing ERAS protocols for gynecologic surgery, breast surgery, total hip replacement and colorectal surgery.

She said the protocol has allowed doctors, nurses and the entire medical team to standardize the care patients get, so it doesn’t matter who the anesthesiologist, nurse or physical therapist is on the day of surgery.

Long added that ERAS has been a way for the hospital to elevate patient care, as they are able to use different techniques to deal with pain other than using opioids.

Joyce Ball, Valley View’s director of DSU/PACU and Procedures, said the multidisciplinary approach to preoperative care ensures better communication for each member of the medical team.

In any business, different team members can be isolated from one another. But ERAS brings all the different disciplines of patient care together for the patient’s benefit, she said.

According to an opinion endorsed by the American Urogynecologic Society, use of ERAS pathways should be strongly encouraged within institutions as it is shown to shorten length of stay, decrease postoperative pain and need for analgesia, decreased complication and readmission rates and increased patient satisfaction.

Studies have shown that, in addition to decreased length of stay, enhanced recovery programs have decreased patient reliance on opioids during post-op, according to UNC School of Medicine.

Grand River Health surgical nurse Tara Keif said the protocol allows them to treat pain and use anesthesia differently.

She added that some cases have seen patients not need any narcotics by doing preventative measures, such as emphasizing optimal nutrition going into a surgery.

“We are enhancing recovery with a few extra steps,” Keif added. “But it took all of the team members to get on the same page.”

In fact, she called the approach to pre- and post-op care somewhat of a change in culture, as doctors, nurses, patients and their families have to all be on the same page before, during and after surgery.

“We are changing the culture one patient at a time,” she added.


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