Austin, Texas-based St. David's HealthCare acute care facility developed the Enhanced Surgical Recovery program to curb patients' dependence on potentially addictive drugs while getting them out of the hospital sooner, KVUE reports.
St. David's pilot program launched in August 2016, and is now used in all the health system's facilities. Paul Loar, MD, medical director of the gynecological oncology program at St. David's North Austin Medical Center, is one of the physicians using the program.
"It went against what we've been doing as the standard of care for decades in big abdominal surgeries — which was kind of starving the patients preoperatively, and then waiting a decent amount of time to readvance diet after surgery in addition to things like lots of narcotics for pain," Dr. Loar told KVUE. "What we found out was that a lot of the things we were doing really weren't necessary, and they were doing more harm than good."
Hospital staff educate patients about the program, which involves enhanced nutritional supplementation, tighter fluid management, multimodal pain control and early mobilization.
How the program works:
- Patients receive a carbohydrate solution to drink two hours before surgery as opposed to fasting before their procedure.
- During the surgery, a noninvasive monitor keeps patients properly hydrated.
- After the surgery, patients receive several different types of medication to reduce pain and avoid opioid medications.
- Physicians encourage patients to move early and often during the entire process — getting them out of the hospital faster.
"I think there are a lot of reasons to like this program," Dr. Loar said. "Word is spreading not only among the doctors but among the patients too."