Enhanced recovery programme in gynaecology: outcomes of a hysterectomy care pathway
- PMID: 26734443
- PMCID: PMC4693102
- DOI: 10.1136/bmjquality.u206142.w2524
Enhanced recovery programme in gynaecology: outcomes of a hysterectomy care pathway
Abstract
There was a wide variation in the peri-operative management of women undergoing hysterectomy for both benign and malignant disease at Southend University Hospital NHS Foundation Trust prior to 2010. The median length of stay following a hysterectomy and more radical gynaecological oncology surgery was five days and seven days respectively. The NHS East of England Strategic Health Authority commissioned the development of Enhanced Recovery Programme (ERP) in various surgical specialties including gynaecology and the pathway was implemented from 2012 onward. Dedicated specialist nurses collected data prospectively. The median length of stay was shortened to three days. This difference was statistically significant with a P value = 0.0001. We describe the successful implementation of an ERP in Southend Hospital resulting with no difference in measurable morbidity and mortality, a shorter length of stay, and a high patient satisfaction scores and outcomes.
References
-
- Razvi K, Spencer C. Enhanced Recovery Programme Guideline; Vaginal , abdominal and laparoscopic hysterectomy. Commissioned by NHS East of England Enhanced Recovery Committee. December 2011; 1–16.
-
- Kehlet H, Dahl JB. Anaesthesia, surgery, and challenges in postoperative recovery. Lancet 2003. Dec 6 ;362(9399)1921–8. Available from: http://www.ncbi.nlm.nih.gov/pubmed/14667752. - PubMed
-
- Kehlet H, Wilmore DW. Evidence-based surgical care and the evolution of fast-track surgery. Ann Surg 2008. Aug ;248(2)189–98. Available from: http://www.ncbi.nlm.nih.gov/pubmed/18650627. - PubMed
-
- Gouvas N, Tan E, Windsor A, Xynos E, Tekkis PP. Fast-track vs standard care in colorectal surgery: a meta-analysis update. Int J Colorectal Dis 2009. Oct;24(10)1119–31. Available from: http://www.ncbi.nlm.nih.gov/pubmed/19415308. - PubMed
-
- Lu D, Wang X, Shi G. Perioperative enhanced recovery programmes for gynaecological cancer patients. Cochrane database Syst Rev 2012. Jan;12:CD008239. Available from: http://www.ncbi.nlm.nih.gov/pubmed/23235656. - PubMed
LinkOut - more resources
Full Text Sources
Other Literature Sources