VGH empowers patients like never before

Last month, Mario Clores spent four nights at Vancouver General Hospital (VGH) recovering from colon surgery.

“It was a great experience,” he says. “The nurses, the doctors…the whole team was great and I’m doing pretty good right now because of it.”

Mario was one of four test colorectal surgery patients for the Enhanced Recovery After Surgery (ERAS) program, a new evidenced-based protocol that reduces the body’s stress response to surgery, thereby reducing complications and creating a more pleasant experience for the patient.

From pre-op to post-op

The ERAS protocol covers every stage of the patient’s journey, from pre-op to post-op, including:

• more robust pre-op education for the patient on what to anticipate, preparing for surgery (eg: consume a carbohydrate drink before leaving home) and their role in recovery
• limited use of fluids during surgery to avoid hypervolemia
• Gum chewing to reduce postoperative ileus
• keeping the patient warm in the OR and recovery room
• early ambulation and post-op patient education on pain control and diet while still on the in-patient unit

“It’s a very comprehensive program involving everybody in the roles of pre-op, inter-op and post-op who care for the patient,” says Tracey Hong, a National Surgical Quality Improvement Program (NSQIP) coordinator who co-led implementation with Andrea Bisaillon, operations director, surgical services. “It provides the best care for the patient, but it also promotes team building because there’s so much emphasis on working together.”

Sharon Lam, a nurse clinician on unit T8, sits on the ERAS steering committee and says that with this teamwork, patient care is much more organized and efficient.

“Following the ERAS protocol, I have a much better idea of what’s happening next for the patient,” she says. “They’re like guidelines, they give me an idea of how to plan the day and set goals in the patient’s care.”

Patients active team members in recovery

Tracey says that the results of the test patients, including Mario, are encouraging.

“ERAS reduces post-op complications and improves the patient’s experience – it’s proven,” says Tracey who has been a nurse for more than 20 years. “One of the key areas of ERAS is getting the patient actively involved in the recovery. They’ll know what to anticipate before surgery and they’ll know what we expect from them after surgery – they’re active team members and not just a passive receiver of care anymore.”

Mario, who returns to work at DHL Canada this month, says he knew exactly what he needed to do to have a good recovery.

“Tracey told me what to do and answered my questions,” says Mario. “It made a difference. It wasn’t very painful and everything’s gone pretty smoothly since – I’m on the mend.”

VGH is leading the way within Vancouver Acute to implement ERAS. Because of the encouraging results it has seen in patients like Mario, the hospital fully implemented the program in VGH units T8 and T9 this month.

“With ERAS, we empower the patient and we empower the staff to do their best,” Tracey says.