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In this one-hour webinar, a multidisciplinary team from Hospices Civils de Lyon (Édouard Herriot and Croix-Rousse hospitals) shows how they built and sustain a prehabilitation day hospital for patients undergoing major digestive surgery. It is aimed at surgeons, anaesthesiologists, ERAS® nurses, physiotherapists, dietitians and managers who want to add prehabilitation to an ERAS® pathway. You will learn how the day hospital is organised, how physical and nutritional preparation is delivered, and which factors decide whether a programme succeeds.
The session covers the prehabilitation day hospital model, where patients meet the prehabilitation nurse, anaesthesiologist, ERAS® nurse, physiotherapist and dietitian in one visit, followed by a weekly phone call. The physiotherapists present a three-week home programme built on respiratory physiotherapy, aerobic exercise and muscle strengthening, with results from 58 colorectal patients (an average of 18.5 days of preparation) and 22 pancreatic patients (15 days), where the 6-minute walk test improved by 22.5 m and 31.7 m respectively in patients under 70. The dietitian and nurse from Croix-Rousse explain nutritional prehabilitation in liver and pancreatic surgery, including malnutrition in cirrhosis and pancreatic insufficiency after resection. Dr Julie Périnel closes with the key factors for implementation – a dedicated multidisciplinary team, a coordinator, institutional support and compliance reporting through a prospective database and audit, as with the ERAS® Interactive Audit System (EIAS) – and the limitations the team still faces.
Speakers
- Dr Julie Périnel
Digestive and Pancreatic Surgeon, Hôpital Édouard Herriot, Hospices Civils de Lyon – clinical lead of the Prehabilitation Day Hospital; opens the session and presents implementation, key success factors and challenges. - Florence Abraham
ERAS® Nurse Coordinator, Hôpital Édouard Herriot, Hospices Civils de Lyon – presents the prehabilitation day hospital model and the audit data. - Aina Moral-Alzaga
Physiotherapist, Hôpital Édouard Herriot, Hospices Civils de Lyon – presents the physical prehabilitation programme (recorded). - Marta Gonzalez-Pereira
Physiotherapist, Hôpital Édouard Herriot, Hospices Civils de Lyon – presents the physical prehabilitation programme (recorded). - Sarah Achatoui
Dietitian, Hôpital de la Croix-Rousse, Hospices Civils de Lyon – presents nutritional prehabilitation in liver and pancreatic surgery (recorded). - Doriane Lionti
ERAS® Nurse, Department of Digestive Surgery and Liver Transplantation, Hôpital de la Croix-Rousse, Hospices Civils de Lyon – presents nutritional prehabilitation in liver and pancreatic surgery (recorded). - Marie Meunier
Encare – host and moderator.
Chapters
- 00:00 Welcome and introduction
- 02:37 Programme overview
- 04:11 The prehabilitation day hospital model
- 13:05 Data collection, audit and first results
- 17:57 Physical prehabilitation: assessment and respiratory physiotherapy
- 21:15 Aerobic training and muscle strengthening
- 24:52 Results: functional capacity and body composition
- 28:50 Nutritional prehabilitation in liver surgery
- 37:58 Nutritional prehabilitation in pancreatic surgery
- 44:56 Implementing and sustaining prehabilitation
- 53:16 Limitations and challenges
- 56:43 International survey and conclusions
- 58:54 Closing remarks
Related resources
- ERAS® Interactive Audit System (EIAS) – Encare's audit system for ERAS® compliance and outcomes
- ERAS® Society – guidelines and the ERAS® programme
- ERAS® Centres of Excellence
- ERAS® colorectal protocol, liver protocol and pancreas protocol
- Hospices Civils de Lyon
Want to see how EIAS can support prehabilitation and ERAS® audit in your hospital? Book a demo