November 2013–March 2015
The National Orthopaedic Enhanced Recovery after Surgery (ERAS) Quality Improvement Collaborative took place between November 2013 and March 2015. The 18 participating district health boards (DHBs) implemented ERAS principles for people having elective hip and knee replacement and acute patients with fractured neck of femur.
ERAS is an evidence-informed multi-modal approach that aims to ensure patients are in the best possible condition for surgery and receive the best possible care during and after their surgery. The principles of ERAS are centred on delivery of best practice for patients at each step of the patient journey, from initial consultation through to pre and post-surgery, rehabilitation and longer-term follow-up.
The findings of this collaborative support the theory that patients who receive care according to ERAS principles have better clinical outcomes and better experiences of care. More people having total joint arthroplasty are now receiving evidence-based, patient-centred care, resulting in an improved patient experience and a shorter hospital stay but without increasing post-operative complications or acute readmissions.
Similarly, acute patients with fractured neck of femur and their families are better informed about the care patients will receive. Patients are being prepared and taken to surgery sooner and mobilised earlier post-operatively. When these practices are combined with other ERAS principles such as adopting agreed analgesic and anaesthetic regimes, patients recover sooner and have lower post-operative morbidity.