Enhanced Recovery After Surgery (ERAS) is a model of care that involves the implementation of care pathways before, during and after surgery designed to improve patient’s experience throughout the perioperative period. Yet, the implementation of individual ERAS protocol elements is not sufficient. This approach requires the creation of a multidisciplinary work team, systematic recording of data and mthe use of the information recorded to implement a cycle of continuous improvement. Since 2015, 1331 patients have been recorded by Hospital Italiano de Buenos Aires. Median length of hospital stay was 4 days and median readmission rate was 7.3%. The overall adherence to the protocol elements was 56% (88% in the preoperative period, 60% in the intraoperative period and 39% in the postoperative period) There was a linear and inverse correlation between the adherence to the program and length of hospitalization for the most common surgical procedures, with an average decrease of one day of hospitalization for each 10% increase in adherence with the program for the most common surgical procedures. Despite these results, we have encountered difficulties in the data recording systems limiting the implementation of the cycle of continuous improvement. The creation of a multidisciplinary team, with fluent and efficient communication, is essential for the implementation of an ERAS® program capable of reducing length of hospital stay, morbidity and readmission rates.
From 2015 to date, the authors of this review have implemented several enhanced recovery periope- rative programs in Latin America. In the following article, we present a general introduction to the con- cepts of perioperative optimization and summarize our experience working in the region. Throughout this review, readers will also find the three fundamental elements of perioperative optimization. First, the creation and roles of a perioperative team. Second, the systematic and standardized registration of the surgical practice and its outcomes. And finally, the description of the continuous improvement cycle as a working method for adjusting daily practice based on the analysis of one’s own data.
We are honored to have received the invitation to be the editors of this special issue of the Revista Argentina de Cirugía entirely devoted to perioperative enhanced recovery. This new paradigm of surgical care is continually becoming more widely accepted worldwide and its cornerstones are elements that do not require major technological advances, funding, or special talents
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