Enhanced Recovery After Colorectal Surgery

Historically there have been countless paths to recovery following colorectal surgery. However, having a well-rounded, evidence-based enhanced recovery program is critical to patient success. Two Vizient experts, Mark Ninno and Karen Smethers discuss the details and the power of these programs.

 

 Guest speakers:

Mark Ninno, PharmD

Senior Consulting Solutions Director

Vizient

 

Karen Smethers, PharmD, BCOP

MSS Pharmacy Network

Senior Director

Vizient Pharmacy Member Services

 

Moderator:

Gretchen Brummel, PharmD, BCPS

Pharmacy Executive Director

Vizient Center for Pharmacy Practice Excellence

 

Show Notes:

[01:21] Enhanced recovery programs are specific programs designed to help patients after surgery

[01:59] Strong recovery programs involve four pillars to achieve its goal of patient discharge: patient-centered, multi-modal, multidisciplinary and evidence-based approaches

[03:29] Vizient observes that health systems have a wide variety of practices following colorectal surgery

[03:56] Vizient gathered a panel of experts to assess and evaluate recovery programs

[04:16] The expert panel focused on two specific domains: literature review and expert opinion    

[05:33] Vizient evidence review includes pharmacological and non-pharmacological interventions

[06:09] Early introduction of oral feeding proved to have the strongest support in recovery

[06:24] Studies involving alvimopan contain many factors that hinders its application in an enhanced recovery program

[07:10] Vizient found many systems are supporting alvimopan use in minimally invasive surgery even though the evidence may not fully support this practice

[07:46] Non-drug regiments such as chewing gum and caffeine have been handed down for many years, yet these therapies have minimal benefits

[08:33] It’s critical for front line pharmacists to collaborate with all health care professionals

[08:59] Education of prescribers, patients and family members provide many benefits

 

Links | Resources:

American Association of Nurse Anesthesiology (AANA): Enhanced Recovery after Surgery Click here

Scott MJ, Baldini G, Fearon KCH, et al. Enhanced Recovery After Surgery (ERAS®) for gastrointestinal surgery, part 1: pathophysiological considerations. Act Anaesthesiol Scand. 201559(10):1212-1231 Click here

Gustafsson UO, Scott MJ, Hubner M, Et al, Guidelines for perioperative care in elective colorectal surgery: Enhanced Recovery After Surgery (ERAS®) Society recommendations: 2018. World J Surg. 2019 ;43(3):659-695 Click here

 

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