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MDHB involved in Enhanced Recovery after Surgery project

MDHB involved in Enhanced Recovery after Surgery (ERAS) project

30 July 2014

MidCentral District Health Board, like other DHBs, is taking part in the national Enhanced Recovery after Surgery (ERAS) programme aimed at improving patient outcomes and recovery after orthopaedic surgery.

The programme is being co-ordinated nationally by the Ministry of Health and focuses on the involvement of the patients being active participants in their own recovery. It also aims to ensure that patients always received evidence-based care at the right time.

ERAS principles of care are focused on three key areas: - preparing the patient for surgery; during surgery; and after surgery.

MidCentral District Health Board’s operations director hospital services, Lyn Horgan said: “MDHB has been running successful knee and hip joint replacement clinics for the past three years, having a 100 percent success rate with all patients attending clinics - a forerunner to the national ERAS collaborative approach. These clinics provide patients and support people with information at all three phases of the patient’s journey. Three booklets are given to patients to reinforce information given to patients at clinics, along with interactive discussions with health professionals on what patients (and their families/whanau) can expect before, during and after surgery.

“The joint clinics have been beneficial to all parties involved – the patients; staff; and the hospital. For patients they have benefited by knowing exactly what is involved – from expected pain levels and how to cope; to what they can eat; exercise, taking care of themselves before surgery; to knowing when and what to expect after surgery, and with their rehabilitation and full recovery.

“For staff they have benefited from getting to know their patient before and right through their discharge and recovery; by better understanding their patient’s requirements; by being better able to plan a patient’s journey from admission through to discharge and recovery.

“From a hospital point of view, it is better able to plan when surgery can take place knowing the reduced average length of stay the clinics have provided; able to schedule staff through surgery and with rehabilitation of patients, including physiotherapy sessions.

“The ERAS programme also includes patients admitted to hospital who have fractured their neck of femur, the focus is from St John ensuring they keep the patient warm, provide appropriate pain relieving measures and adequate hydration to the emergency department, and highlighting the arrival into the hospital to alert key staff thus ensuring the patient is fast tracked to an inpatient bed or to the operating theatre.

“The patient follows a clearly defined clinical pathway which focuses on surgery as soon as possible and mobilisation within 24 hours of the surgery. This is a multi-discipline approach with input from elder health, pharmacists, dieticians, allied health staff along with the nurses and doctors on the specialist orthopaedic ward. A patient journey fractured neck of femur booklet is in the final draft, which when printed will keep patients and their families well informed of what to expect in hospital,” she said.


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