ERAS
About Us
The Enhanced Recovery After Surgery (ERAS) program helps to improve the quality and outcomes for our patient’s during surgery and the post-operative period. We do this by standardizing the perioperative practices, collaborating with our partners throughout the UT Southwestern enterprise and using evidence-based interventions for our patients along their surgical journey.
Mission Statement
The mission of the ERAS program is to drive improvement for surgical patients by applying best practices across the hospital system. We engage patient(s) to be an active participant in their own care and bring all the experts in the perioperative process to the table to design the best plans using evidence-based medicine for optimal outcomes.
Goals
- The typical primary goals of this program are to decrease the length of stay (LOS) for patients after surgery and to improve overall pain control.
- Other goals include: reduced complications, costs, opioid use; increased patient/provider satisfaction and bed availability
- These pathways are often the gold-standard of care within their surgical specialty and are all tailored specifically for our institution and surgical patient population
Data
| Surgical Line | ERAS Surgeries Performed | Percentage of ERAS Cases |
|---|---|---|
| Stone | 710 | 16.79% |
| Prostatectomy | 574 | 13.57% |
| Gynecology Benign | 472 | 11.16% |
| Spine | 379 | 8.96% |
| Colorectal | 371 | 8.77% |
| Other* | 1723 | 40.74% |
*Includes the following surgical lines: Cystectomy, RPLND, Liver, HIPEC, Bariatric, Gynecology Oncology, Geriatric Hip, Hip Knee Arthroplasty, Plastics, Female Pelvic, Mas Tissue, and Shoulder Arthroplasty.
Collaborations
- Bariatric
A unique patient population needs a unique perioperative plan, and ours aims specifically to decrease postoperative nausea and vomiting which is a major limiting factor in patient recovery and discharge.
- Colorectal
This is one of our most successful collaborations led by a strong surgical team; we aim to prevent infection and return bowel function as soon as possible in these surgical cases.
- Female Pelvic Reconstruction
This pathway is designed to minimize narcotics and get the majority of our patients out of the hospital on the same day of surgery.
- Gynecology - Hysterectomy, Myomectomy, Exploratory laparoscopic Surgery
Over 90% of patients undergoing these procedures go home on the same day.
- Gynecology Oncology
This group focuses on preventing surgical site infections while also trying to send many patients home on the same day.
- Mastectomy with Tissue Expanders
One of the only pathways of its kind in the country, this pathway is a collaboration with our surgical oncologists and plastic surgeons for optimal outcomes after surgery.
- Orthopedic Geriatric Hip Fracture
Specifically designed with older adults in mind, we emphasize early pain control with nerve blocks to decrease narcotic use. In combination with the RESTORE program to help UTSW become a Center of excellence for care in geriatric hip fractures.
- Orthopedic Spine
These complex cases are robustly managed in pre-op, intraop, and postop periods to reduce complications and improve pain control in patients who often have pre-existing chronic pain.
- Orthopedic THA
Designed to get patients up and moving as quickly as possible after surgery.
- Orthopedic TKA
Use of regional analgesia techniques help reduce opioid-induced side effects and let patients start physical therapy quickly.
- Orthopedic TSA
A well established pathway that uses nerve blocks to better control pain after surgery with the goal of day-of-surgery discharge.
- Otolaryngology- Microlaryngoscopy
Our newest pathway uses unique airway techniques to help surgical exposure and also get patients through the recovery area and out of the hospital as quickly and safely as possible.
- Plastic - Breast Reconstruction with Free Flap
This is one of our most successful pathways with robust data showing decreased length of stay, narcotic usage and outcomes. Patients now go straight to the recovery room and the floor rather than the ICU after surgery.
- Surgical Oncology HIPEC
This pathway combines unique pain control regimens and fluid management strategies to minimize the morbidity associated with these complex procedures.
- Surgical Oncology Liver resection
With these often major surgeries, our surgeons and anesthesiologists work in concert to provide the best care for our patients.
- Urology Cystectomy
One of our original pathways, now 7 years of patients/data show decreased length of stay and impressive outcomes.
- Urology Prostatectomy
Clement's University Hospital is a clear leader in robotic prostatectomy care, and this frequently used pathway makes sure each patient gets ideal, standardized care.
- Urology RPLND
This pathway combines various multimodal pain control techniques to optimize postop pain control.
- Urology Stone extraction
Our most used pathway with pain control in mind, this pathway is uniquely designed so that ureteroscopy patients go home the same day while PCNL patients are comfortable enough to leave after their CT scans show no stones.
Our People
ERAS Program Director
Division Lead - Urology and Women's Services Programs
Anesthesia Champion - Stone extraction
Vice Chair of Adult Operations at University Hospitals and Parkland Health and Hospital Systems
Vice Chair for University Hospitals
