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Abstract
Introduction/Background Enhanced Recovery After Surgery (ERAS) protocol is a comprehensive transformation of the surgical process that have revolutionised postoperative care across various surgical specialties.
Beyond implementation of ERAS, we designed a complete change of the surgical process with the aim of improving, not only the quantitative results (stays, complications) but the qualitative (both satisfaction patients and professionals). For that, we obtained a European grant (FEDER-RISC3CAT) of €1,134,000, which involved purchase of materials, devices, and a shared risk consultancy with MEDTRONIC (Data and Project manager) for the implementation of the whole new process, including prehabilitation, ERAS and new data registry with an automated dashboard on the results.
Methodology ERAS process was first conducted at University Hospital of Bellvitge in Barcelona. The protocol creation involved a multidisciplinary team, encompassing over 50 professionals, gynecologists, anaesthesiologists, nursing staff, nutritionists, and physiotherapists.
The registry underwent a significant transformation, transitioning from text-based clinical history to structured variable records filled during clinical stages. These variables auto-generate a standard clinical course and populate a database for periodic result evaluation.
To asses the protocol’s impact, we measured hospital stay, complications, readmissions, and patient-reported outcomes. Using standardized questionnaires (PREMs for communication, support, and comfort, and PROMs for health indicators), data was collected via automated phone or app communication tailored to each patient.
Results After implementation, during the pilot phase, significant improvements were seen despite an already high starting point. Hospital stay reduced by 2.9 days, postoperative complications decreased notably, and pain management improved. Professional satisfaction increased with a 9.4/10 recommendation index as implementation progressed.
Conclusion The successful implementation of the ERAS protocol has enhanced surgical care by optimizing the process and collecting data that underscores its effectiveness. This emphasizes its ongoing significance in improving outcomes and the patient experience.
