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Perioperative Integration Promotes Enhanced Recovery After Surgery

By Sonya Pease, MD, Chief Medical Officer, Anesthesiology

TeamHealth Benefits of Integrating Perioperative Care

Imagine for a moment that you’re a 50-year-old, otherwise, healthy patient with a new diagnosis of colon cancer found during routine screening colonoscopy. You now need a right colon resection. How do you select your surgeon or the hospital where you’ll have surgery? Does your anesthesiology care really make any difference? Do you care about coordination between the surgeon, anesthesiologist and hospitalist? TeamHealth does. 

What if I told you that if you have your surgery at a hospital where your surgeon, anesthesiologist and hospitalist team all participate in an Enhanced Recovery After Surgery (ERAS) Program, you would have a shorter post-operative stay, a lower incidence of anastomosis breakdown, a lower postoperative complication rate, ability to eat sooner, better pain control, ability to return your daily activities sooner with no increased risk of readmission? Would you choose this hospital over another that does not have an ERAS Program in place?

We have entered the era of precision medicine where the care and treatment of each patient is as individualized as the disease process being treated. There is now robust evidence to support the benefits of ERAS protocols over traditional surgical care, and as our patients become more educated consumers, we need to be actively engaged in leading these integrated perioperative care pathway designs within our facilities.

TeamHealth Anesthesiology embarked on the ERAS journey more than four years ago by enrolling seven of our partner healthcare organizations in the Perioperative Surgical Home (PSH) Learning Collaborative. We currently have two of our healthcare organizations enrolled in the second collaborative, an advanced demonstration project. The results of adopting surgical home initiatives like ERAS are impressive and impactful for our patients as well as for our hospital clients. For example, All Saints Hospital in Racine, Wisconsin, implemented both the rapid hip and ERAS protocols under the PSH model. Through ERAS, All Saints Hospital elective colorectal surgery patients experience:

  • 78 percent reduction in total doses of opioids used in the postoperative period
  • 50 percent reduction in postoperative pain scores for the first two days after surgery (2.6 vs. 3.9)
  • One day reduction in length of stay (3.3 vs. 4.1)
  • One day reduction in time to ambulation (0.9 vs. 1.8)
  • Cost savings of more than $2,000 per patient episode of care

On the other side of the country, Legacy Good Samaritan Medical Center in Portland, Oregon, saw:

  • A three-day reduction in length of stay (6.7 days to 3.7 days)
  • An estimated cost savings of $4,803 per patient
  • No increase in the rates of postoperative complications or 30-day readmissions

Coordinated integrated care benefits our patients and is critical to the financial success of our organization and the healthcare facilities we serve. Together, we can design and implement innovative approaches to patient care that improve clinical quality and patient safety, improve a hospital’s key performance metrics, reduce complications and readmissions, and enhance the overall patient experience.

Visit our website to see how TeamHealth can help enhance your patient care.