The program has been shown to reduce length of stay, complications, and costs for colorectal surgery patients.
The patient safety team at the Johns Hopkins Armstrong Institute for Patient Safety and Quality will be introducing "enhanced recovery after surgery" (ERAS) protocols to 750 US hospitals.
The Hopkins team will help hospitals adopt the approach through its Comprehensive Unit-Based Safety Program (CUSP).
CUSP as "a five-step culture change intervention that engages front-line healthcare staff members in preventing harm." It is designed to "overcome the lack of local buy-in that often dooms improvement efforts."
Peter Pronovost, MD, PhD, director of the Armstrong Institute, said in statement that the program will combine the ERAS and the CUSP approaches "together into one coordinated, unified program where everyone—clinicians, patients, and their loved ones—understand what they must do for the best possible outcome."
After the program was put into place at Hopkins, length of stay, complications, and costs dropped for colon surgery patients. For these patients, Hopkins reported a 1.5-day reduction in LOS, a 50% decrease in surgical-site infections, and $1,500 savings in hospital costs.
The American College of Surgeons (ACS), which will work with Hopkins on the effort, notes in a statement that trainees will get a toolkit and "support from a senior executive to help overcome any barriers they may face."
The ACS will recruit hospitals for the project, which will initially focus on abdominal operations in colorectal surgery. ERAS, however, is expected to eventually be applied to bariatric surgery, orthopedic surgery, gynecology, and emergency general surgery among other procedures.
Introduced in Europe, ERAS is described by the ACS as a combination of "preoperative, intraoperative, and postoperative practices that have been shown to decrease surgical patients' complications and speed their recovery."
It uses patient and family engagement, limits pre-operative fasting periods, and applies methods of pain control that reduce the need for opioids. The ERAS effort involves surgeons, anesthesia providers, and nurses.
Johns Hopkins has received $4 million in support from the Agency for Healthcare Research and Quality to roll out the program, and will be eligible for additional funds over the next three years.