Background and importance Surgery complications, hospital stay length and patient satisfaction are hospital quality indicators. The implementation of an Enhanced Recovery after Surgery (ERAS) programme is an ideal strategy to improve those indicators and humanise clinical activities in hospitals.
Aim and objectives To evaluate the impact of an ERAS programme and a preoperative consultation on health outcomes and patient-reported outcomes (PROs).
Material and methods In March 2021, an ERAS programme for knee joint replacement was implemented by a multidisciplinary team of orthopaedics, nurses and pharmacists. The group developed new standardised perioperative protocols and a preoperative multidisciplinary consultation (‘school of patients’), where chronic medication is reconciled by the pharmacist and it is explained to patients what knee joint replacement surgery is.
An observational and prospective study was conducted in all patients operated for knee joint replacement from March to June 2021. Main health outcomes were hospital stay length, readmissions after 30 days and surgery cancellations due to incorrect drug management. Concerning PROs, patients were asked about their satisfaction about the school and pain management, and their quality of life before and after surgery (EuroQol 5D (EQ-5D)).
Results A total of 61 patients were attended; 60.66% of them were female and mean age was 82 (ICR 71.9–86.9) years. The median number of chronic drugs was 6 (ICR 3–9). The median hospital stay length was 4 days (ICR 3–6), whereas it was 7 days in 2019 (ICR 2–52).
No surgery cancellations or hospital readmissions within 30 days after surgery took place.
Patient satisfaction with pain management was 8.30/10. Mean pain visual analogue scale (VAS) score 24 hours after surgery was 2.63. Patients referred to a mean improvement in their mobility and in their knee pain after the surgery of 0.55 (p=0.02) and 0.73 points (p=0.02), respectively.
Self-reported health rating was 62.42 before the surgery and 77.27 afterwards (p<0.05).
The school earned an overall satisfaction rating of 9.8/10.
Conclusion and relevance The implementation of an ERAS programme has proven highly successful in accomplishing faster recovery, which has led to a reduction in hospital stay length and surgery cancellations. In addition, the programme achieved good PROs (high patient satisfaction and an optimal pain management).
Conflict of interest No conflict of interest
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