Challenges and opportunities in enhanced recovery after surgery programs: An overview.

IF 2.9 Q1 ANESTHESIOLOGY Indian Journal of Anaesthesia Pub Date : 2024-11-01 Epub Date: 2024-10-26 DOI:10.4103/ija.ija_546_24
Vijaya Gottumukkala, Girish P Joshi
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Abstract

Enhanced Recovery After Surgery (ERAS) programs were developed as evidence-based, multi-disciplinary interventions in all the perioperative phases to minimise the surgical stress response, reduce complications, and enhance outcomes. The results across various surgical procedures have been positive, with a reduction in medical complications, a reduction in length of hospital stay, and a reduction in care costs without increased re-admission rates. However, implementation for many institutions has not been easy and suboptimal at best. The robust and pervasive adoption of these programs should be based on effective change management, dynamic and engaged clinical leadership, adherence to the principles of continuous quality improvement programs, and the adoption of evidence-based and data-driven changes in pathway development and implementation. Rapid cycle, randomised/quasi-randomised quality improvement projects must be the core foundation of an ERAS program. Finally, research methodologies should focus on controlling for adherence to the core elements of the pathways and testing for the effectiveness of an individual intervention in a randomised controlled trial.

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提高术后恢复的挑战和机遇:综述。
加强术后恢复(ERAS)项目是围手术期所有阶段的循证、多学科干预措施,旨在最大限度地减少手术应激反应,减少并发症,提高预后。各种外科手术的结果都是积极的,减少了医疗并发症,缩短了住院时间,降低了护理费用,而没有增加再入院率。然而,对许多机构来说,实施起来并不容易,充其量也不是最理想的。这些项目的有力和普遍采用应基于有效的变革管理、动态和参与的临床领导、坚持持续质量改进项目的原则,以及在途径开发和实施中采用循证和数据驱动的变革。快速循环,随机/准随机质量改进项目必须是ERAS项目的核心基础。最后,研究方法应侧重于控制对途径核心要素的依从性,并在随机对照试验中测试个体干预的有效性。
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来源期刊
CiteScore
4.20
自引率
44.80%
发文量
210
审稿时长
36 weeks
期刊最新文献
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