From Personal Perspective

Personal Perspective: ERAS – Ongoing Quality Improvement Changes to Surgical Care

“Personal Perspectives” provide a space for practitioners and patients to offer their personal views about any aspect of enhanced recovery. “Personal Perspectives” do not necessarily reflect the views of the ERAS Collaborative in general. If you would like to contribute your personal perspective, please contact the Project Manager

ERAS – Ongoing Quality Improvement Changes to Surgical Care

By Deborah Bachand, RN, BA; formerly Manager of Quality Improvements for Surgical Services at Island Health and Member of BC Enhanced Recovery Collaborative Advisory Panel

Change.  I love words, and I’ll bet that many of you are tired of that one. The Oxford English Dictionary tells us it is an old word with Celtic origins; that it can be used as a noun, and a verb both with and without direct objects, that an altered form is also an acceptable adjective.

I have seen a lot of change in my 40 plus years of nursing – mostly good and mostly beneficial to people – our patients. Some changes I have disagreed with.

I disagreed with the move to the BSN program, which purports to train bedside nurses with limited access to the bedsides of real patients. I disagreed with the ‘primary care’ nursing model, which broke down the bonds of teamwork and in my opinion made a hard job harder. But I came around. And then I recently sat in on a local forum where our university community met with the nursing professional standards body to discuss what to do about nurses coming out of the current BSN programs, none of whom at that table considered ‘practice ready’. And most of us are aware of, or have been embroiled in the conflict between health authority administrators, staff, managers and nursing unions over the change back to team nursing – aka CDMR – Care Delivery Model Redesign.

Change is difficult but as someone once said: Change is inevitable – resistance is futile. We can’t undo the changes to university degree nursing or the changes brought about by resource stresses in health care but we can change the way we deliver care to ensure that patients are getting the best we can provide based on statistical evidence, carefully measure outcomes, and by being attentive to the needs of our patients and their desire to get back to life as they knew if before they heard the words “you will need surgery”.

By now you may all be wondering what this has to do with ERAS. Reflect for a moment on ERAS as the new change for surgical care – spreadable, sustainable. Think about how we can never go back to the way things were.

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Personal Perspective: Preparing a Patient for Surgery by Pamela Jessen, Patient Partner

“Personal Perspectives” provide a space for practitioners and patients to offer their personal views about any aspect of enhanced recovery. “Personal Perspectives” do not necessarily reflect the views of the ERAS Collaborative in general. If you would like to contribute your personal perspective, please contact the Project Manager

Preparing a Patient for Surgery

By Pamela Jessen, ERAS Collaborative Patient Partner

Surgical programs are continuously developing or refining their patient education materials. I’d like to share two personal stories that demonstrate how a patient preparing for surgery can have a positive or negative experience. Though I am not an ERAS patient, I have undergone multiple surgeries and believe that patient empowerment through education has the power to affect health outcomes for any type of surgery, minor or major.

Several years ago, I was scheduled for a Nissen Fundoplication for severe GERD. The surgeon I met with took me verbally through the surgery steps and explained that I would be on a liquid diet for several weeks. I left his office feeling somewhat educated, but wishing there was more information on what would take place, especially from a patient’s viewpoint. Read more

Personal Perspective: Why does Canadian healthcare need the Enhanced Recovery Society of Canada? by Dr. Ron Collins

“Personal Perspectives” provide a space for practitioners to offer their personal views about any aspect of enhanced recovery. “Personal Perspectives” do not necessarily reflect the views of the ERAS Collaborative in general. If you would like to contribute your personal perspective, please contact the Project Manager. Read on for our first personal entry by Dr. Ron Collins.

Why does Canadian healthcare need the Enhanced Recovery Society of Canada?

(an excerpt from the Enhanced Recovery Society of Canada website, which will go live soon, enhancedrecovery.ca)

By Dr. Ron Collins, ERAS Collaborative Anesthesia Co-Chair; Executive Medical Director, Quality & Patient Safety – Interior Health; Staff Anesthesiologist – Kelowna General Hospital.

There are reasons to believe that the Canadian health care system is facing huge challenges.  In fact, some projections suggest that in its present form, the Canadian health care system is approaching an unsustainable state.  This is clearly unacceptable to our vision of Canada as a society, to Canadians who need access to care and to those who function as stewards of Canadian health care, trying to direct its course.

The potential failure of Canada’s health care system is personally unacceptable to me because I have three children who, while early in their journey of life, will someday likely interact with the health care system, and it is part of my personal vision to ensure that, when they need it, the health care system meets their needs in terms of care and compassion as well as access, quality and reliability.

Given that context, then, what is Enhanced Recovery, and what does it promise to Canadian health care?  Read more