TAMPA, Fla. - In July 2015, Moffitt anesthesiologists and urologists formalized an Enhanced Recovery after Surgery (ERAS) protocol for patients whose entire bladder is removed. By working together they developed an ERAS program incorporating evidence-based best practices of urology and anesthesia and newer techniques and maneuvers in order to create a multidisciplinary approach to perioperative care.
ERAS is comprehensive, covering all areas of a patient’s journey through surgery. The key factors that keep patients in the hospital after surgery include the need for administering medication intravenously and delayed recovery of bowel function. The central elements of the ERAS protocol address these key factors. In addition, the ERAS pathway provides a framework to all involved in perioperative care, helping them to work as a well-coordinated team to provide the best care.
Since implementing ERAS:
- Patient stay has been reduced by an average of one day.
- Physicians began using narcotic sparing anesthetic technique due to incorporation of intraoperative thoracic epidural analgesia using local anesthetic.
- Intraoperatively, patients receive goal directed fluid therapy, which uses a cardiac stroke volume optimization algorithm.
- Patients have required less intraoperative blood transfusions.
- Hospital charges have decreased by approximately $3,500/person.
- Communication between providers and patients has been standardized, consistent and greatly improved.
- Rate of postoperative readmission has been reduced.
The team is examining the effect of ERAS on long-term outcomes such as incidence of complications at 30 and 90 days after surgery and cancer-specific outcomes such as rate of cancer recurrence.
About Moffitt Cancer Center
Moffitt is dedicated to one lifesaving mission: to contribute to the prevention and cure of cancer. One of the three largest cancer centers in the United States based on patient volume, the Tampa-based facility is one of only 47 National Cancer Institute-designated Comprehensive Cancer Centers, a distinction that recognizes Moffitt’s excellence in research, its contributions to clinical trials, prevention and cancer control. Moffitt is the top-ranked cancer hospital in Florida and has been listed in U.S. News & World Report as one of the “Best Hospitals” for cancer care since 1999. Moffitt devotes more than 2 million square feet to research and patient care. With more than 5,000 team members, Moffitt has an economic impact in the state of $1.9 billion. For more information, call 1-888-MOFFITT (1-888-663-3488), visit MOFFITT.org, and follow the Moffitt momentum on Facebook, Twitter and YouTube.