In 2014 I became involved with an anesthesiologist here at the hospital to utilize and measure ERAS performance on our patients. I admit, at the time I became a part of the team purely out of selfish reasons. My mother has had diverticulitis for almost 20 years and knowing this methodology might be used in her surgery greatly influenced my involvement. I knew the time would likely come that a portion of her large intestine would need to be removed.
ERAS involves carb loading a patient prior to surgery. That is, you are able to eat just hours prior to surgery. The idea is to nourish the cells as much as possible to make the gut pliable and encourage healing. ERAS also involves NO narcotic use. Pain is controlled through a low thoracic epidural.
In 2014, we got encouraging results on 22 patients who had open gut procedures. By 2017, we'd performed ERAS on over 200 patients. Length of stay was anywhere from 2 to four days shorter than for our peer group who didn't do ERAS, and our patients had no more readmissions than the control group.
I'm 2016, my mom had an open gut to remove about 1/4 of her colon. I sought out the physician leader in my data for performing these surgeries. She had a 3 hour procedure, and the next day, ambulated to a chair (that's required--ambulation post op day one). She also could eat post op day one. She received NO narcotics. She was discharged in 4.3 days. Generally, patients with these surgeries are discharged in about a week.
Using math, and the saved days, this project can potentially save Methodist $4 million. We are using it on multiple types of surgeries now--not just open guts. Patients like it because they get to leave earlier, so they experience a cost saving, and so do we. This protocol is also being used in patients with cancer.
I can't begin to tell you how many bell curves and tests of confidence I've run. It's a lot. Our group posts huge statistically significant gains over our control group.