The decision to have surgery is a serious one that often comes with many patient concerns. How long will I be in the hospital and what will recovery be like? What are the complication risks, and how soon until I can get back to my regular routine? These are common, valid concerns for anyone considering a surgical procedure.

Fortunately, surgery and the processes around it have come a long way in recent years, and WakeMed is leading the way in improving surgical outcomes with a unique program called ERAS – also known as Enhanced Recovery After Surgery. Aimed at improving recovery, reducing pain and decreasing complications, ERAS is a powerful tool to help surgical patients get back to their lives and feeling better faster than ever.

What is ERAS?

In simple terms, ERAS is an emerging model used around the world to help reduce a patient’s surgical stress response, optimize their physiological function and facilitate a faster recovery. It’s an evidence-based care pathway that includes a series of activities before, during and after surgery that, when combined, lead to better outcomes.

While the specific actions/steps for each ERAS protocol will vary based on each procedure, an example of the steps included in ERAS may include:

• Participating in “prehab” to help patients improve functional capabilities prior to surgery
• Drinking a carbohydrate drink such as Powerade/Gatorade three hours before surgery
• Chewing gum shortly after surgery to decrease nausea and promote bowel function
• Implementing innovative pain management protocols that treat swelling and pain with less opioids
• Getting up and moving more quickly after surgery

“While each of these steps may seem ‘small,’ research shows that when combined, they’re having a major impact on surgical outcomes and recovery,” explains Gina McConnell, BSN, RN, CCRN, WakeMed ERAS program coordinator.

ERAS at WakeMed

In April 2017, WakeMed became the first hospital in the country to introduce ERAS for open heart surgery patients. Almost immediately, our heart patients experienced shorter hospital stays, less pain, fewer complications and faster recovery times. Seeing these remarkable outcomes, physicians from across numerous specialties began asking how to implement ERAS in other clinical areas. Since then, WakeMed Cary Hospital has introduced ERAS for the following specialties:

• Thoracic (Lung) Surgery – lung lobectomy and wedge resection procedures
• OB/GYN – C-sections and select gynecological procedures
• General Surgery – hernia, colorectal and breast procedures
• Urology – ureteroscopy (kidney stone stent placement) procedures
• Bariatrics – gastric sleeve, gastric bypass, gastric banding, duodenal switch and gastric banding procedures
• Orthopaedics – knee replacement procedures

“Surgery represents a major life event for thousands of WakeMed patients each year and can be stressful,” explains McConnell. “ERAS is an incredibly powerful program that is making surgery and the recovery process significantly easier on our patients. We have seen remarkable improvements in our outcomes across all specialties where ERAS has been implemented, and our patients are grateful for the opportunity to get home and back to their routines sooner than ever.”