Growth of Enhanced Recovery After Surgery (ERAS) across the US

July 30, 2019

According to an article written in Anesthesiology News, Enhanced Recovery After Surgery, or ERAS, is seeing continued growth and adoption in hospitals across the United States. A survey conducted by Dr. Sunitha Singh, ERAS coordinator at Stony Brook University Medical Center, showed colorectal surgery (88% of respondent facilities) as being the most popular ERAS program, followed by gynecology (51%), orthopedics (49%), surgical oncology (38%)and urology (35%). 

It was expected that colorectal would be the most represented among the 148 returned surveys as it was the focus of many early ERAS efforts. 4.6% of hospitals that responded to the survey reported having no ERAS program. 

The total number of ERAS programs in a hospital was positively correlated to the number of ORs and to the presence of anesthesia and surgery residency programs.

According to another expert quoted in the article, Dr. Anoushka Afonso, ERAS Director at Memorial Sloan Kettering, ERAS programs are a great way to improve care and save money. However, Dr Afonso opines that many hospitals still have not implemented them due to the high need for collaboration among many departments and stakeholders including the surgeons, anesthesiologists and OR staff. To increase involvement, education and research must be presented and it is important for OR leadership and administration to support and encourage the efforts. 

EHC Note: In our experience working with hospitals and health systems across the country we have come across ORs of all sizes with a wide range of ERAS programs in place (not uncommonly none). If a hospital is not already involved or actively pursuing ERAS, if supported by adequate specialty case volume, it is often our recommendation to explore implementation. These programs have the potential to not only improve patient outcomes and care, but also may drive cost savings through standardization, reduced length of stay and reduced perioperative complications. Oftentimes, we look to the anesthesia department to spearhead implementing and maintaining ERAS programs. While anesthesiologists are an important part of the ERAS puzzle because they are directly involved in all stages of the perioperative process, they must obtain significant support to create a successful program.  We typically see significant involvement of senior champions in the target surgical specialty and senior hospital leadership, as well as OR managers, and pre and post op managers. While adding ERAS programs will require a significant outlay of time and energy, the potential benefits are meaningful both clinically and financially.