Vanderbilt University Medical Center is launching an enhanced recovery after surgery (ERAS) pathway for the nearly 1,000 adult patients who undergo elective spine surgery each year at Vanderbilt University Hospital and Belle Meade Surgery Center.
With the aim of helping patients recover more quickly, leave the hospital earlier, and experience fewer side effects from pain management, the pathway was developed jointly by the Department of Neurological Surgery, the Division of Spine Surgery (part of the Department of Orthopaedic Surgery), and the Department of Anesthesiology.
“ERAS is at the core of our efforts to ensure consistent and continually improving care practices across our surgical service lines,” said ERAS executive sponsor Warren Sandberg, MD, PhD, professor and chair of the Department of Anesthesiology and chief of staff at VUH. “VUMC teams have shown over and over that with ERAS approaches patients simply fare better. The hospital and Anesthesiology remain committed to helping more surgical service lines realize these benefits.”
ERAS originated in Denmark with studies published in the early 1990s. Key elements of ERAS include patient and family education, minimizing the physiological stress of surgery, optimizing pain management with minimal opioid use, and continuously evaluating outcomes for improvement opportunities.
VUMC began adopting ERAS in 2014 and now has 11 adult ERAS pathways: colorectal surgery, gynecological surgery, c-section, hip/femur fractures, cystectomy, surgical weight loss, complex hernia repair, total hip/total knee replacement, soft tissue sarcoma surgery, pancreatic/hepatobiliary cancer surgery, and now, spine surgery. Pediatric ERAS pathways at VUMC include complex hip surgery, scoliosis surgery, sports surgery, colorectal surgery, pectus excavatum surgery, urologic surgery, and cardiac surgery.
The spine surgery ERAS pathway team was led by surgeons Scott Zuckerman, MD, MPH, Julian Lugo-Pico, MD, and Raymond Gardocki, MD; anesthesiologists Lane Crawford, MD, Daniel Larach, MD, MSTR, and Letha Mathews, MBBS; and advanced practice providers Crystal Parrish, APRN, John Hatcher, APRN, Jacki Ford, PA, Alan Hendon, CRNA, and Tammy Freehling, CRNA.
Jennifer Jayaram, MSN, is clinical director for ERAS at VUH, and Dana Andersen, MBA, is the program manager.
Other areas represented on the pathway development team included Nursing (hospital, clinic, perioperative), Nursing Education, Patient Education, Pain Management, the Section of Hospital Medicine, Infection Prevention, Rehabilitation Services, Enterprise Data Analytics, Operations Improvement, and the eStar Builders program.
