|| Checking for direct PDF access through Ovid
The enhanced recoveryprogramme was introduced to improve post operative patient outcomes. It has been successfully adopted in several institutions with good results.All consecutive patients undergoing elective colorectal resections and large hernia repairs within a 3-year period (2006-2008) were included (n = 169) in the study. A standard enhanced recoveryprotocol was followed. In 2008 a specialist enhanced recovery nurse was appointed to oversee theprogramme and participant education was vigorously instigated. A hospital booklet wasproduced for the duration of treatment clearly stipulating daily goals. Outcomes were re-audited in a second cohort of 179 patients over an 18 month period (2008-2009).Mean length of stay was reduced from 8 to 6.5 days, mortality from 2.11% to 0.72% and short-term morbidity from 1.88% to 1.55% (P < 0.05 for all variables). Significantly, mean length of stay decreased further to 5.6 days after the specialist enhanced recovery nurse was appointed. Protocol parameters were achieved in more than 90% of cases and no adverse effects associated with theprogramme were observed.Implementation of enhanced recoveryprogrammes using a multidisciplinary approach can lead to significant improvement in patient outcomes. Based on this experience, further expansion of theprogramme to include other complexprocedures may be advantageous.