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In this German-language webinar, the ERAS® teams from Charité – Universitätsmedizin Berlin and the University Medical Center Hamburg-Eppendorf (UKE) share how they have implemented ERAS® in gynecology and gynecologic oncology. It is aimed at gynecologic surgeons, anesthesiologists, nurses and hospital teams who are starting or developing an ERAS® program. You will learn why ERAS® is about strengthening the patient's health rather than only avoiding complications, how frailty assessment and prehabilitation fit into the pathway, and what the ERAS® nurse does before and after surgery.
Prof. Jalid Sehouli opens with the patient journey: why functional status matters more than chronological age, why sarcopenia, quality of life and polypharmacy should be assessed before surgery, and why de-escalation – no classic bowel preparation, no unnecessary drains, shorter fasting with carbohydrate loading up to two hours before surgery – is as important as adding new measures. Prof. Barbara Schmalfeldt describes how the UKE started its program in 2018 with one entity, ovarian cancer, how the interprofessional team and the ERAS® nurse are organized, and how regular audits improved compliance, reduced fluid administration and shortened length of stay. Dr Susanne Reuter then follows a 60-year-old patient with suspected ovarian cancer through the UKE ERAS® pathway – from patient information, brochures and the patient diary to intraoperative and postoperative compliance in the audit – and describes how the 24-hour monitoring unit (PAKO24) was introduced for patients after multivisceral surgery. Dr Lee from the Charité presents the KORE-INNOVATION project, which combined ERAS® with personalized trimodal prehabilitation based on a comprehensive frailty assessment, including early feedback from patients. Two ERAS® nurses close the presentations: Henriette Thorau on preoperative assessment and education, and Freya Brodersen on postoperative ERAS® nurse rounds, the 30-day telephone follow-up and process evaluation with the ERAS® Interactive Audit System (EIAS). The discussion covers the contribution of nursing, compliance items that are hard to implement – drains, patient blood management and long-acting opioids – and how to keep the program alive when staff change.
Speakers
- Prof. Dr. Jalid Sehouli
Director, Department of Gynecology with Center for Oncological Surgery, Charité – Universitätsmedizin Berlin – leads the Charité ERAS® team; gives the introduction on ERAS® in gynecology and comments in the discussion. - Prof. Dr. Barbara Schmalfeldt
Director, Department of Gynecology, University Medical Center Hamburg-Eppendorf (UKE) – leads the UKE ERAS® team; presents the implementation of ERAS® at the UKE. - Dr Susanne Reuter
Department of Gynecology, University Medical Center Hamburg-Eppendorf (UKE) – presents a clinical case through the UKE ERAS® pathway and the evaluation of the PAKO24 monitoring unit, and answers questions on compliance. - Dr [PLATSHÅLLARE – förnamn] Lee
[PLATSHÅLLARE – titel], Department of Gynecology with Center for Oncological Surgery, Charité – Universitätsmedizin Berlin – presents prehabilitation in the context of ERAS® and the KORE-INNOVATION project. - Henriette Thorau
ERAS® Nurse, [PLATSHÅLLARE – sjukhus/avdelning] – presents the role of the ERAS® nurse and preoperative care. - Freya Brodersen
ERAS® Nurse and Advanced Practice Nurse (M.Sc.), University Medical Center Hamburg-Eppendorf (UKE) – presents postoperative ERAS® nurse care, telephone follow-up and process evaluation. - Annabelle Burkhardt
Customer Development Manager, Encare – host and moderator.
Chapters
- 00:00 Welcome and introduction
- 02:45 ERAS® in gynecology: the patient journey (Prof. Jalid Sehouli)
- 07:45 What affects recovery and drives complications
- 12:17 Age, frailty, sarcopenia and polypharmacy
- 17:19 De-escalation: leaving out what is not needed
- 19:17 Fasting, carbohydrate loading and walking into the operating room
- 21:23 Fluid management and bowel preparation
- 25:40 Prehabilitation and three groups of frailty
- 28:16 What disrupts an ERAS® pathway
- 32:44 Implementing ERAS® at the UKE (Prof. Barbara Schmalfeldt)
- 39:00 The UKE ERAS® team and patient pathway
- 43:32 Implementation phase, training and audit
- 47:17 Results: compliance, fluids and length of stay
- 50:52 Clinical case presentation (Dr Susanne Reuter)
- 54:04 The patient: suspected ovarian cancer
- 57:13 Patient information and brochures
- 59:49 ERAS® in daily practice: SOP and flowcharts
- 1:01:18 Surgery and intraoperative compliance
- 1:04:28 Postoperative course and outcome
- 1:06:56 Evaluation and the PAKO24 monitoring unit
- 1:10:28 Prehabilitation in the context of ERAS® (Dr Lee, Charité)
- 1:15:34 KORE-INNOVATION: frailty assessment and personalized prehabilitation
- 1:18:30 What patients say about prehabilitation
- 1:23:32 The role of the ERAS® nurse (Henriette Thorau)
- 1:29:26 The preoperative pathway with the ERAS® nurse
- 1:32:46 Postoperative care and ERAS® nurse rounds (Freya Brodersen)
- 1:37:59 30-day telephone follow-up
- 1:39:27 Process evaluation with EIAS
- 1:41:07 Discussion: the contribution of nursing
- 1:45:53 Discussion: drains, patient blood management and opioids
- 1:50:06 Discussion: training and staff turnover
- 1:52:04 Closing remarks
Related resources
- ERAS® Interactive Audit System (EIAS) – Encare's audit system for ERAS® compliance and outcomes
- ERAS® Implementation Program (EIP) – a structured program for introducing ERAS® in a hospital
- ERAS® gynecology protocol
- ERAS® Society – guidelines and the ERAS® program
- KORE-INNOVATION trial – the Charité-led study of a perioperative care pathway with prehabilitation for patients with ovarian cancer
- ERAS® Qualification and the map of ERAS® Qualified Centers
Want to see how EIAS can support ERAS® implementation and audit in your gynecology department? Book a demo