Financial challenges in the health sector have been exacerbated by the COVID-19 pandemic. Improved surgical recovery protocols can help healthcare systems reduce length of stay, minimize post-surgical infections, and decrease readmissions, which can provide much-needed financial relief.
During a webinar in November hosted by Becker’s Hospital Review and sponsored by Cardinal Health, Keith Beiermeister, MD, general colon and rectal surgeon at Scripps Memorial Hospital La Jolla, Calif., Discussed the current financial challenges and how whose ERAS protocols have made a difference in several lines of service at Scripps. RosieMarie (Rosie) Squeo, RN, Senior Consultant at Cardinal Health, shared an example of a surgical kit option adopted by Scripps as part of its ERAS program.
- The current health care system is not financially sustainable and needs to be changed. Healthcare spending in the United States topped $ 4 trillion in 2020, with more than 30% of spending on hospital services. Hospital costs averaged $ 2,607 per day and nosocomial infections cost $ 9.8 billion. “We have to start doing things that work and stop doing things that don’t work,” Dr Beiermeister said. “What we need – COVID or no COVID – is a system that shortens length of stay, reduces complications, and reduces readmissions. “
- ERAS is a proven and evidence-based multidisciplinary approach to reduce hospital stay, reduce costs and increase patient satisfaction. Developed over two decades ago for colorectal surgery, ERAS is arguably an accelerated recovery program for all surgical patients. It begins with patient education during the presurgical assessment and includes such things as early removal of drains and tubes, rapid ambulation, and rapid transition to pain relievers in a postoperative setting. “All of this leads to increased patient satisfaction,” said Dr Beiermeister. “We are focusing on reducing perioperative complications and length of stay, as well as making better use of hospital resources. “
- Over time, several lines of service at Scripps have increased participation in ERAS with clear trends towards shorter stays, fewer complications and fewer readmissions. For example, colorectal surgeries started using ERAS protocols in 2017 and have made significant and steady progress. “When we look at our baseline data, we’ve cut the length of our hospital stay in half; it’s a big saving for the hospital, ”said Dr Beiermeister. Scripps has integrated the ERAS protocols in gynecology, bariatrics and its cardiac arrest program. “I think what we’re starting to see in our most recent efforts is a decrease in the length of our stay in intensive care, which is going to have a huge impact on cost savings,” he said. he adds.
- Multidisciplinary education, communication and cooperation are the keys to change. An example at Scripps involved the implementation of an ERAS surgical kit program. Originally, the Office of Colorectal Surgeons ordered and assembled all the components of a patient colorectal surgery kit. It was a tedious and time consuming process for the staff. When Cardinal Health proposed to create a personalized surgery kit, there were concerns that the sales rep was simply selling a new product. “We had to educate the material management team, physician’s office, clinicians and managers on the need for this ERAS kit program as well as the benefits and savings it would bring to patients,” said Mrs. Squeo.
“These relatively simple, evidence-based practices can change our trajectory,” said Dr Beiermeister. “They have the added benefit of fostering interdisciplinary collaboration and culture, which is especially needed now when we are grappling with personnel issues. ERAS protocols can reduce costs and improve the value of surgical care for our patients. “
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* Dr. Beiermeister is a paid consultant for Cardinal Health