ENHANCE ERAS® WITH ENCARE
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Author: Magnus Olofsson

Hospital Universitario Fundación Valle de Lili, Colombia, is ERAS® Qualified

Posted on by Magnus Olofsson

The Colorectal Team of Valle del Lili Cali in Colombia initially started their ERAS® Implementation Program in November of 2021.

Despite starting during the pandemic and its associated challenges, they mastered the implementation through excellent teamwork.

With a strong team they have implemented solid and lasting processes and were ERAS® Qualified in October, 2023. They were trained and coached by Dr Angela Navas of ERAS® Center of Excellence, CLINICA REINA SOFIA BOGOTA, Colombia.

To learn more how to become ERAS® Qualified, please read here.

Ospedale Sacro Cuore Don Calabria: the 1st Italian ERAS® trainer

Posted on by Magnus Olofsson

IRCCS Ospedale Sacro Cuore Don Calabria in Negrar di Valpolicella (Verona) is the first ERAS® Trainer in Italy.

IRCCS Ospedale Sacro Cuore Don Calabria Team, after ERAS® Qualification on 2022, has been able to sustain its ERAS® work on 2023 and uphold good results in terms of compliance towards the ERAS® Society guidelines as well as improving patients’ outcomes. They have been supported by the Encare partner Medtronic along the way.

Based on this, they were in November 2023 invited to participate in the so called “ERAS® Train-the-Trainer” session where they were trained and coached by the ERAS® Center of Excellence Valenciennes Hospital in France.

As a result, the team composed by Dr. Ruffo, Dr.ssa Bertocchi, Dr.ssa Masini, Dr. Rossini, Dr.ssa Gentile, Dr. Menestrina and Dr.ssa Freoni was then selected to become the first ERAS® Trainer in Italy.

We are looking forward to continuing supporting the team to spread ERAS® in Italy as well as wish them continued success in sustaining their ERAS® work and improve care for their patients!

Read more here about how to become ERAS® Qualified.

Ospedale Santa Maria becomes an ERAS® Qualified Center

Posted on by Magnus Olofsson

The Chirurgia Generale e Bariatrica- Ospedale Santa Maria S.p.A. (General and Bariatric Surgery, Santa Maria Hospital), G.V.M. Group, Bari, Italy recently completed their ERAS® Implementation Program within Bariatric Surgery.

Lead by Doctor Antonio Braun, they have been able to implement and improve their perioperative processes and show tremendous results to now become an ERAS® Qualified Center in less than a year.

Their compliance to the ERAS® Society guidelines were high initially and despite this, they were able to further increase this and as a result further improve their patient’s outcome.

The team has been supported by Encare’s partner Medtronic and they were trained by Dr Guido Liddo, Dr Stéphane Ilunga and ERAS® Coach Agathe Gennin of the ERAS® Center of Excellence Valenciennes Hospital, France.

We wish them continued success in sustaining their ERAS® work and improve care for their patients!

To learn more how to become ERAS® Qualified, please read here https://encare.net/eip-eras-implementation-program/

ENCARE INTRODUCES EIAS PROTOCOL FOR CARDIAC SURGERY

Posted on by Magnus Olofsson

We’re thrilled to announce that we are now offering an additional EIAS Protocol for Cardiac Surgery to the ERAS® Interactive Audit System (EIAS).

BENEFITS OF ERAS® FOR CARDIAC SURGERY

  • One full day reduction of Length of Stay (1, 2) and reduction of ICU stay by up to 16h (1, 2, 3)
  • Significant cost savings of 1909€/patient (8)
  • Fewer rates of blood transfusion (4), reduced post-op urinary tract infections by 4,7% (2), reduced post-op ventilator incidences by 2.9% (2), lower post-op pain scores (4)
  • Reduced 30-day mortality by 3.5% (2) for open aortic procedures and 0.7% for cabg/valve operations (2)
  • Reduced opioid-use by 25-79% (1, 5, 6, 7)
  • Reduced postoperative reinterventions for tamponade or hemothorax, and atrial fibrillation (9, 10, 11)
  • Early detection and intervention of AKI (12, 13, 14) and Delirium (15, 16)

 

CARDIAC PROCEDURES COVERED IN THE NEW PROTOCOL INCLUDE:

  • CABG
  • Aortic Surgery
  • Valve Surgery
  • Surgical Ablation/Maze
  • Cardiopulmonary bypass (CPB)
  • Other Cardiac Procedure, except Afib

 

COMPLIANCE AREAS COVERED IN THE PROTOCOL:

  • Perioperative Opioid use
  • Perioperative SSI prevention
  • Patient Blood Management
  • Acute Kidney Injury (AKI)
  • Delirium
  • Atrial Fibrillation

 

The guidelines based on best practice allow standardization of the perioperative pathway for cardiac surgery.

With Encare’s solutions for ERAS® implementation (ERAS® Interactive Audit System and ERAS® Implementation Program) we support you in making the most out of the guidelines.

WHY CHOOSE EIAS?

With our platform, you’re adopting a truly evidence-based, multidisciplinary, and perioperative approach, based on the most up-to-date clinical knowledge.

EIAS users have reported overall improved patient outcomes by increasing compliance towards the ERAS® Society guidelines and thereby lowering the number of complications, reducing length of stay while at the same time showing substantial cost savings.

SPREAD THE WORD & BOOK A DEMO

We believe that this update can benefit all healthcare providers who perform cardiac surgeries. If this includes you, take the opportunity to begin your true ERAS® journey!

We’re also offering personalized demos to guide you through the new features. Book your slot here and get a hands-on experience as well as a consultation on ERAS®  implementation.

 

 

REFERENCES:

  1. Gebauer A, Konertz J, Petersen J, Brickwedel J, Köster D, Schulte-Uentrop L, Reichenspurner H, Girdauskas E. The impact of a standardized Enhanced Recovery After Surgery (ERAS) protocol in patients undergoing minimally invasive heart valve surgery. PLoS One. 2023 Mar 24;18(3):e0283652. doi: 10.1371/journal.pone.0283652
  2. Obafemi T, Mullis D, Bajaj S, Krishna P, Boyd J. Results following implementation of a cardiac surgery ERAS protocol. PLoS One. 2023 Jul 14;18(7):e0277868. doi: 10.1371/journal.pone.0277868. PMID: 37450443; PMCID: PMC10348550.
  3. Mondal S, Bergbower EAS, Cheung E, Grewal AS, Ghoreishi M, Hollander KN, Anders MG, Taylor BS, Tanaka KA. Role of Cardiac Anesthesiologists in Intraoperative Enhanced Recovery After Cardiac Surgery (ERACS) Protocol: A Retrospective Single-Center Study Analyzing Preliminary Results of a Yearlong ERACS Protocol Implementation. J Cardiothorac Vasc Anesth. 2022 Nov 11:S1053-0770(22)00794-7. doi: 10.1053/j.jvca.2022.11.007.
  4. Maj G, Regesta T, Campanella A, Cavozza C, Parodi G, Audo A. Optimal Management of Patients Treated With Minimally Invasive Cardiac Surgery in the Era of Enhanced Recovery After Surgery and Fast-Track Protocols: A Narrative Review. J Cardiothorac Vasc Anesth. 2022 Mar;36(3):766-775. doi: 10.1053/j.jvca.2021.02.035
  5. Dahl JJ, Krebs ED, Teman NR, Hulse M, Thiele RH, Singh K, Yount KW; UVA Cardiac ERAS group. Cardiac Enhanced Recovery Program Implementation and Its Effect on Opioid Administration in Adult Cardiac Surgery. Semin Thorac Cardiovasc Surg. 2022 Aug 17:S1043-0679(22)00186-1. doi: 10.1053/j.semtcvs.2022.06.020.
  6. Ronald Baxter, John Squiers, William Conner, Michael Kent, James Fann, Kevin Lobdell, J. Michael DiMaio, Enhanced Recovery After Surgery: A Narrative Review of its Application in Cardiac Surgery, The Annals of Thoracic Surgery, Volume 109, Issue 6, 2020, Pages 1937-1944, ISSN 0003-4975, https://doi.org/10.1016/j.athoracsur.2019.11.008.
  7. Rawn Salenger, Sari D. Holmes, Amanda Rea, Jennifer Yeh, Kate Knott, Rachel Born, Michael J. Boss, Linda F. Barr, Cardiac Enhanced Recovery After Surgery: Early Outcomes in a Community Setting, The Annals of Thoracic Surgery, Volume 113, Issue 6, 2022, Pages 2008-2017, ISSN 0003-4975, https://doi.org/10.1016/j.athoracsur.2021.06.072.
  8. Petersen, J., Kloth, B., Konertz, J. et al. Economic impact of enhanced recovery after surgery protocol in minimally invasive cardiac surgery. BMC Health Serv Res 21, 254 (2021). https://doi.org/10.1186/s12913-021-06218-5
  9. Myles PS, Smith JA, Forbes A, et al; ATACAS Investigators of the ANZCA Clinical Trials Network. Tranexamic acid in patients undergoing coronary-artery surgery. N Engl J Med. 2017;376(2):136-148. doi:10.1056/NEJMoa1606424
  10. Grieshaber P, Heim N, Herzberg M, Niemann B, Roth P, Boening A. Active chest tube clearance after cardiac surgery is associated with reduced reexploration rates. Ann Thorac Surg. 2018;105(6):1771-1777. doi:10.1016/j.athoracsur.2018.01.002
  11. St-Onge S, Ben Ali W, Bouhout I, et al. Examining the impact of active clearance of chest drainage catheters on postoperative atrial fibrillation. J Thorac Cardiovasc Surg. 2017;154(2):501-508. doi:10.1016/j.jtcvs.2017.03.046
  12. Mayer T, Bolliger D, Scholz M, et al. Urine biomarkers of tubular renal cell damage for the prediction of acute kidney injury after cardiac surgery: a pilot study. J Cardiothorac Vasc Anesth. 2017;31(6):2072-2079. doi:10.1053/j.jvca.2017.04.024
  13. Khwaja A. KDIGO clinical practice guidelines for acute kidney injury. Nephron Clin Pract. 2012;120(4):c179-c184.
  14. Xie X, Wan X, Ji X, et al. Reassessment of acute kidney injury after cardiac surgery: a retrospective study. Intern Med. 2017;56(3):275-282. doi:10.2169/internalmedicine.56.7638
  15. Siddiqi N, Harrison JK, Clegg A, et al. Interventions for preventing delirium in hospitalised non-ICU patients. Cochrane Database Syst Rev. 2016;3:CD005563.
  16. Young J, Murthy L, Westby M, Akunne A, O’Mahony R; Guideline Development Group. Diagnosis, prevention, and management of

NEWS FOR PANCREATIC SURGERY: THE UPDATED ERAS® INTERACTIVE AUDIT SYSTEM PROTOCOL

Posted on by Magnus Olofsson

WELCOME TO THE FUTURE OF ENHANCED RECOVERY AFTER SURGERY (ERAS®) FOR PANCREATIC SURGERY

We are excited to announce a significant update to the ERAS® Interactive Audit System (EIAS), aligning with the latest published ERAS® Society guidelines on pancreatic surgery.

INTRODUCING THE UPDATED PANCREAS PROTOCOL IN EIAS

The ERAS® Interactive Audit System, a cornerstone for ERAS® implementation, now includes an upgraded pancreas protocol.

This protocol is  designed to reflect the latest ERAS® Society guidelines.

Our commitment to evidence-based care is stronger than ever, ensuring that healthcare providers have access to the most current guidelines for Enhanced Recovery After Surgery.

KEY BENEFITS OF ERAS® WITHIN PANCREATIC SURGERY

  • Reduced Complications and Mortality: The adoption of ERAS® guidelines leads to improved patient outcomes by utilizing the best practices in surgical care.[1, 5, 6]
  • Reduced Length of Stay: Efficient care processes under ERAS® protocols facilitate swift patient recovery, reducing the time spent in hospitals.[1, 4]
  • Significant Cost Savings: Shorter Length of Stay results in lower costs for healthcare facilities.[1, 2, 3]

 

WHY OPT FOR THE ERAS® INTERACTIVE AUDIT SYSTEM?

Choosing to implement ERAS® through Encare’s EIAS (ERAS® Interactive Audit System) and EIP (ERAS® Implementation Program) means adopting a system that’s specifically built for the implementation and auditing of and research within ERAS® .

Users of EIAS have consistently reported higher compliance with ERAS® guidelines, resulting in fewer complications, reduced hospital stays, and substantial cost savings.

SPREAD THE WORD AND EXPERIENCE EIAS FIRSTHAND

We encourage pancreatic surgeons and their teams to explore these updates and embark on their ERAS® journey.

We are offering personalized demos to introduce you to the new features of the ERAS® Interactive Audit System.

Book your slot now for a hands-on experience and expert consultation on implementing ERAS® in your practice.

CONCLUSION

The ERAS® Interactive Audit System, with its updated pancreas protocol, is an opportunity for medical professionals to elevate the standard of care in pancreatic surgery, aligning with the latest ERAS® Society guidelines.

REFERENCES:

  1. Takagi K, Yoshida R, Yagi T, Umeda Y, Nobuoka D, Kuise T, Hinotsu S, Matsusaki T, Morimatsu H, Eguchi J, Wada J, Senda M, Fujiwara T. Effect of an enhanced recovery after surgery protocol in patients undergoing pancreaticoduodenectomy: A randomized controlled trial. Clin Nutr. 2019 Feb;38(1):174-181. doi: 10.1016/j.clnu.2018.01.002. Epub 2018 Jan 9. PMID: 29373148.
  2. Joliat GR, Labgaa I, Petermann D, Hübner M, Griesser AC, Demartines N, Schäfer M. Cost-benefit analysis of an enhanced recovery protocol for pancreaticoduodenectomy. Br J Surg. 2015 Dec;102(13):1676-83. doi: 10.1002/bjs.9957. Epub 2015 Oct 22. PMID: 26492489.
  3. Lof S, Benedetti Cacciaguerra A, Aljarrah R, Okorocha C, Jaber B, Shamali A, Clarke H, Armstrong T, Takhar A, Hamady Z, Abu Hilal M. Implementation of enhanced recovery after surgery for pancreatoduodenectomy increases the proportion of patients achieving textbook outcome: A retrospective cohort study. Pancreatology. 2020 Jul;20(5):976-983. doi: 10.1016/j.pan.2020.05.018. Epub 2020 May 28. PMID: 32600854.
  4. Jesse K. et al  The impact of intraoperative goal-directed fluid therapy on complications after pancreaticoduodenectomy, Annals of Medicine and Surgery, Volume 36, 2018,, Pages 23-28,ISSN 2049-0801, https://doi.org/10.1016/j.amsu.2018.10.018.
  5. Wang XY, Cai JP, Huang CS, Huang XT, Yin XY. Impact of enhanced recovery after surgery protocol on pancreaticoduodenectomy: a meta-analysis of non-randomized and randomized controlled trials. HPB (Oxford). 2020 Oct;22(10):1373-1383. doi: 10.1016/j.hpb.2020.07.001. Epub 2020 Aug 15. PMID: 32811766.
  6. Dai J, Jiang Y, Fu D. Reducing postoperative complications and improving clinical outcome: Enhanced recovery after surgery in pancreaticoduodenectomy – A retrospective cohort study. Int J Surg. 2017 Mar;39:176-181. doi: 10.1016/j.ijsu.2017.01.089. Epub 2017 Jan 26. PMID: 28132917.

UPDATED ERAS® PROTOCOL FOR LIVER SURGERY IS NOW AVAILABLE IN EIAS

Posted on by Magnus Olofsson

WE’RE THRILLED TO SHARE THAT THE ERAS® INTERACTIVE AUDIT SYSTEM NOW INCLUDES THE NEW PROTOCOL FOR LIVER SURGERY

Since the first ERAS® Society guidelines for liver surgery were introduced in 2016[1], there’s been a notable improvement in postoperative patient outcomes, as evidenced by several publications [2, 3] and three recent meta-analyses [4, 5, 6].

These analyses show significant reductions in postoperative complications, LOS, and overall costs thanks to ERAS® implementation.

WHAT’S NEW IN THE GUIDELINES?

The updated guidelines[7] are now exclusively based on studies specific to liver surgery, enhancing their relevance and impact.

This marks a progress from the initial guidelines, where one third of the recommendations were derived from non-liver surgery studies. 25 recommendation items have been elaborated, whereof three are completely new compared to the initial guidelines:

  • Prehabilitation in high-risk patients.
  • Preoperative biliary drainage in cholestatic liver.
  • Preoperative smoking and alcohol cessation at least 4 weeks before hepatectomy.

 

These new guidelines based on best practice allow standardization of the perioperative pathway for liver surgery. With Encare’s solutions for ERAS® implementation (ERAS® Interactive Audit System and ERAS® Implementation Program) we support you in making the most out of the guidelines.

WHY CHOOSE EIAS FOR YOUR ERAS® IMPLEMENTATION?

With our platform, you’re adopting a truly evidence-based, multidisciplinary, and perioperative approach, based on the most up-to-date clinical knowledge. EIAS users have reported increased ERAS® Society guidelines compliance and thereby fewer complications, reduced LOS, and substantial cost savings.

We believe that this update can benefit all healthcare providers who perform liver surgeries. If this includes you, take the opportunity to begin your true ERAS® journey!

Please also share it with your peers within liver surgery.

 

References:

  1. Melloul E, Hübner M, Scott M et al (2016) Guidelines for perioperative care for liver surgery: enhanced recovery after surgery (ERAS) society recommendations. World J Surg 40:2425–2440.
  2. Liang X, Ying H, Wang H et al (2016) Enhanced recovery program versus traditional care in laparoscopic hepatectomy. Medicine (Baltimore) 95:e2835
  3. Liang X, Ying H, Wang H et al (2018) Enhanced recovery care versus traditional care after laparoscopic liver resections: a randomized controlled trial. Surg Endosc 32:2746–2757
  4. Li L, Chen J, Liu Z et al (2017) Enhanced recovery program versus traditional care after hepatectomy: a meta-analysis. Medicine (Baltimore) 96:e8052
  5. Zhao Y, Qin H, Wu Y, Xiang B (2017) Enhanced recovery after surgery program reduces length of hospital stay and complications in liver resection: a PRISMA-compliant systematic review and meta-analysis of randomized controlled trials. Medicine (Baltimore) 96:e7628
  6. Noba L, Rodgers S, Chandler C et al (2020) Enhanced recovery after surgery (ERAS) reduces hospital costs and improve clinical outcomes in liver surgery: a systematic review and meta-analysis. J Gastrointest Surg 24:918–932
  7. Enhanced Recovery After Surgery (ERAS) Society Recommendations 2022. World J Surg 47, 11–34 (2023).
ENHANCE ERAS® WITH ENCARE

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