Abstract：
OBJECTIVE: Enhanced Recovery After Surgery (ERAS) is a multidisciplinary, patient-centred approach aimed at expediting recovery, improving clinical outcomes, and reducing healthcare costs. Initially developed for colorectal surgery, ERAS principles have been successfully applied across various surgical specialties, including cardiac surgery. This study outlines the implementation and certification process of the ERAS program in a tertiary cardiac surgical centre within the Heart-Vessel Department at Lausanne University Hospital.
METHODS: The implementation involved forming a multidisciplinary team, including cardiac surgeons, anaesthesiologists, intensivists, a cardiologist, clinical nurse specialists, and physiotherapists. The ERAS nurse coordinator played a central role in organizing meetings, promoting the program, developing protocols, and collecting data. The certification process required adherence to ERAS guidelines, structured training, and external evaluation. Key phases included pre-ERAS data collection, protocol dissemination, inclusion of the first patients, followed by analysis and full implementation.
RESULTS: Achieving certification required maintaining a compliance rate of over 70% with established protocols. The process involved overcoming various barriers, such as inconsistent practices and the need for multidisciplinary collaboration. In this paper, we provide some solutions to these challenges, including team education, regular meetings, and continuous feedback loops. Preliminary data from the initial cohort showed improvement in early mobilization, opioid use, respiratory complications, and shorter hospital stays.
CONCLUSIONS: The successful implementation of the ERAS program at our institution demonstrates the feasibility and benefits of a structured, multidisciplinary approach in cardiac surgery. Continuous self-assessment and adherence to guidelines are essential for sustained improvement in patient outcomes and healthcare efficiency.
METHODS: The implementation involved forming a multidisciplinary team, including cardiac surgeons, anaesthesiologists, intensivists, a cardiologist, clinical nurse specialists, and physiotherapists. The ERAS nurse coordinator played a central role in organizing meetings, promoting the program, developing protocols, and collecting data. The certification process required adherence to ERAS guidelines, structured training, and external evaluation. Key phases included pre-ERAS data collection, protocol dissemination, inclusion of the first patients, followed by analysis and full implementation.
RESULTS: Achieving certification required maintaining a compliance rate of over 70% with established protocols. The process involved overcoming various barriers, such as inconsistent practices and the need for multidisciplinary collaboration. In this paper, we provide some solutions to these challenges, including team education, regular meetings, and continuous feedback loops. Preliminary data from the initial cohort showed improvement in early mobilization, opioid use, respiratory complications, and shorter hospital stays.
CONCLUSIONS: The successful implementation of the ERAS program at our institution demonstrates the feasibility and benefits of a structured, multidisciplinary approach in cardiac surgery. Continuous self-assessment and adherence to guidelines are essential for sustained improvement in patient outcomes and healthcare efficiency.
摘要：
目的：手术后加速恢复（ERAS）是一个多学科，以患者为中心的方法旨在加快康复，改善临床结果，降低医疗成本。最初是为结直肠手术开发的，ERAS原则已成功应用于各种外科专业，包括心脏手术.这项研究概述了洛桑大学医院心脏血管部三级心脏外科中心ERAS计划的实施和认证过程。
方法：实施涉及组建多学科团队，包括心脏外科医生,麻醉师,密集主义者，心脏病专家,临床护士专家，和物理治疗师。ERAS护士协调员在组织会议中发挥了核心作用，推动该计划，制定协议，和收集数据。认证过程要求遵守ERAS准则，结构化培训，和外部评估。关键阶段包括ERAS前数据收集，协议传播，纳入第一批患者，其次是分析和全面实施。
结果：要获得认证，必须对已建立的协议保持70%以上的合规率。这个过程涉及克服各种障碍，例如不一致的做法和多学科合作的必要性。在本文中,我们为这些挑战提供了一些解决方案，包括团队教育，定期会议,和连续的反馈循环。最初队列的初步数据显示早期动员有所改善，阿片类药物的使用，呼吸系统并发症,缩短住院时间。
结论：ERAS计划在我们机构的成功实施证明了结构化，心脏外科多学科方法。持续的自我评估和遵守指南对于持续改善患者预后和医疗保健效率至关重要。
方法：实施涉及组建多学科团队，包括心脏外科医生,麻醉师,密集主义者，心脏病专家,临床护士专家，和物理治疗师。ERAS护士协调员在组织会议中发挥了核心作用，推动该计划，制定协议，和收集数据。认证过程要求遵守ERAS准则，结构化培训，和外部评估。关键阶段包括ERAS前数据收集，协议传播，纳入第一批患者，其次是分析和全面实施。
结果：要获得认证，必须对已建立的协议保持70%以上的合规率。这个过程涉及克服各种障碍，例如不一致的做法和多学科合作的必要性。在本文中,我们为这些挑战提供了一些解决方案，包括团队教育，定期会议,和连续的反馈循环。最初队列的初步数据显示早期动员有所改善，阿片类药物的使用，呼吸系统并发症,缩短住院时间。
结论：ERAS计划在我们机构的成功实施证明了结构化，心脏外科多学科方法。持续的自我评估和遵守指南对于持续改善患者预后和医疗保健效率至关重要。
