Orthopedic Surgery in Enhanced Recovery After Surgery

Wainwright, Thomas W; Immins, Tikki

doi:10.1007/978-3-030-33443-7_49

Cited by 2 publications

(2 citation statements)

References 75 publications

(78 reference statements)

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“… 8 To move towards the goal of a ‘pain and risk-free surgery’, clinical evidence of individual techniques must be combined with a whole clinical microsystem QI effort in order to do ‘the right things in the right way’. 9 …”

Section: Discussionmentioning

confidence: 99%

Wanting to improve is not always the same as knowing how to improve—an example from a total knee arthroplasty pathway

Wainwright

Craig²

2020

BMJ Open Qual

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Section: Discussionmentioning

confidence: 99%

Wanting to improve is not always the same as knowing how to improve—an example from a total knee arthroplasty pathway

Wainwright

Craig²

2020

BMJ Open Qual

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“…This is because even though ERAS pathways have been proven to improve clinical outcomes, their delivery is context-dependent, and as they are developed, changes need to be holistically informed. Improving a clinical outcome is achieved by combining clinical decisions informed by evidence-based medicine (such as an ERAS protocol) with the needed process or system changes, that allow the right things to be delivered in the right way [ 20 ]. Understanding this concept is crucial, and when combined with effective leadership, a supportive organisational culture, and an infrastructure to collect data, units will be able to understand how to improve their pathways.…”

Section: Ensuring the Successful Implementation And Adaptation Of mentioning

confidence: 99%

Enhanced Recovery after Surgery (ERAS) for Hip and Knee Replacement—Why and How It Should Be Implemented Following the COVID-19 Pandemic

Wainwright

2021

Medicina

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The COVID-19 pandemic has led to a reduction in hip and knee replacement surgery across healthcare systems. When regular operating returns, there will be a large volume of patients and an emphasis on a short hospital stay. Patients will be keen to return home, and capacity will need to maximised. Strategies to reduce the associated risks of surgery and to accelerate recovery will be needed, and so Enhanced Recovery after Surgery (ERAS) should be promoted as the model of care. ERAS protocols are proven to reduce hospital stay safely; however, ERAS pathways may require adaption to ensure both patient and staff safety. The risk of exposure to possible sources of COVID-19 should be limited, and so hospital visits should be minimised. The use of technology such as smartphone apps to provide pre-operative education, wearable activity trackers to assist with rehabilitation, and the use of telemedicine to complete outpatient appointments may be utilised. Also, units should be reminded that ERAS protocols are multi-modal, and every component is vital to minimise the surgical stress response. The focus should be on providing better and not just faster care. Units should learn from the past in order to expedite the implementation of or adaption of existing ERAS protocols. Strong leadership will be required, along with a supportive organisational culture, an inter-professional approach, and a recognised QI method should be used to contextualize improvement efforts.

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Orthopedic Surgery in Enhanced Recovery After Surgery

Cited by 2 publications

References 75 publications

Wanting to improve is not always the same as knowing how to improve—an example from a total knee arthroplasty pathway

Wanting to improve is not always the same as knowing how to improve—an example from a total knee arthroplasty pathway

Enhanced Recovery after Surgery (ERAS) for Hip and Knee Replacement—Why and How It Should Be Implemented Following the COVID-19 Pandemic

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