Enhanced recovery protocols vary, but they always work, says surgeon

In the modern era of healthcare, surgeries have grown less invasive and recovery times have shrunk as more emphasis is placed on recovery at home.

Keith Beiermeister, MD, colorectal surgeon at Scripps Memorial Hospital in La Jolla, Calif., told "Becker's ASC Review Podcast" that enhanced recovery after surgery protocols go a long way toward achieving that end, even if their components don't seem substantial.

Note: This is an edited excerpt. Listen to the full podcast episode here.

Question: How has your hospital been incorporating enhanced recovery after surgery protocols? 

Dr. Keith Beiermeister: [Enhanced recovery] was sort of an initial labor of love for me and I was kind of doing it on my own because I saw the benefits for my patients. It is a multidisciplinary program where you involve a lot of different physicians and administrators and other healthcare practitioners to come up with this protocol to benefit your patients as a whole throughout the operative process. 

We saw such unbelievable results with our own patients that we shared that with the hospital and they very quickly got on board and supported us. And then we spread the word to the other people, from anesthesia to nursing and administration. 

We're now a little over four years into our program and we have since established protocols in a few different service lines, including gynecology, oncology, bariatric surgery and most recently, cardiac surgery, which went live October 2020. We just got some initial data from that, and all those programs have been very successful.

This is going to be a very hospital-specific process for others. There are the obvious groups that need to be involved when you talk about enhanced recovery. Generally speaking, they're driven by either the surgical side or the anesthesia side.

When you start showing your numbers, [administration] will very quickly be on board with you because this stuff just works. It's unbelievable how a group of seemingly simple changes put together in a package can have such a dramatic impact on things like length of stay, opiate use, surgical site infections and readmission rates.

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