Bon Secours St. Francis adopts Enhanced Recovery After Surgery method

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GREENVILLE, S.C. (WSPA) – Over the past year, Bon Secours St. Francis has seen big results after beginning to use a different recovery method for patients healing from colorectal surgeries.

It’s method born in Europe in the 1990s called Enhanced Recovery After Surgery that became more commonly used to the United States around 2010, but is now making its way to the Upstate.

Studies show it is resulting in major improvements in clinical outcomes and cost and is reducing length of hospital stays.

The method involves frequent communication with staff weeks before the surgery, drinking high protein shakes starting a week before surgery and only using narcotic drugs as a last resort.

“Enhanced recovery pathways are designed to improve patient outcome by better preparing patients for their surgical procedure,” Bon Secours St. Francis Anesthesiologist Ross Simril explains. “We want patients to get up, get to walking [and] eating within hours after surgery… returning to their natural function as soon as possible.”

At Bon Secours St. Francis, an Enhanced Recovery Coordinator works with patients before and after surgeries so they’re more prepared for surgery physically. 

“Traditionally we would have patients come in, see the surgeon, be scheduled for surgery several weeks out and really had no contact between the initial visit and showing up for the pre assessment testing a couple days before surgery,” Dr. Simril says. “With enhanced recovery, there’s more opportunity for the patient to ask questions.”

Before hearing about the new method for recovery, patient Kevin Poole was worried about undergoing a painful process for her colon re-section surgery in April.

“My mom has had a colon resection two times to remove cancer from her colon,” Poole says. “She could not even drink water. So I was looking for the same experience she did.”

Poole’s mother was in the hospital recovering for 9 days on morphine, which was normal under the traditional recovery method, but her own experience was much different, since she was a candidate for the Enhanced Recovery After Surgery method.

“The day of the surgery, I was up in a chair and walking around the hallway at the hospital and eating with minimal pain,” she says.

Dr. Simril explains that under the ERAS method, patients prepare their body to heal with protein drinks up to two hours before surgery.

“Traditionally… patients showed up essentially in starvation state. In enhanced recovery we’re looking to eliminate that because we’ve seen it improves patient outcome, decreases stress and better control, in diabetics, their glucose levels.”

During and after surgery, Dr. Simril is primarily using medications like Ibuprofin and IV Lidocaine to improve pain control.

“The amount of narcotics used have been greatly decreased, and currently, that’s a main focus within the medical field,” he says. “Patients tend to recover faster and feel better when they avoid narcotics.”

In the past year since they’ve adopted the new method for colorectal surgeries, Dr. Simril says he’s seen a steady decrease in length of hospital stays.

“We’re looking to have patients feeling good enough to go home 2 or 3 days before surgery. Traditionally this could have taken a week.”

Bon Secours St. Francis plans to expand this method to bariatric and gynocologic surgeries, which Dr. Simril believes will increase same day discharges. 

For more information about ERAS, click here.

To submit a question for our series, click here. You can also hear from experts at Bon Secours St. Francis on this topic and others every Saturday morning at 10am on 106.3 WORD radio.  

Copyright 2019 Nexstar Broadcasting, Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.

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