In 2014, the Enhanced Recovery After Surgery (ERAS) program launched in Northern California, and traditional surgical care as we knew it was changed forever. The principles of ERAS include multimodal analgesia, early mobilization, maintenance of adequate nutrition, and active patient participation in their care.
In 2014, the Enhanced Recovery After Surgery (ERAS) program launched in Northern California, and traditional surgical care as we knew it was changed forever. The principles of ERAS include multimodal analgesia, early mobilization, maintenance of adequate nutrition, and active patient participation in their care. ERAS was successfully implemented as an evidence-based, multi-disciplinary care pathway that brought together staff and departments across care settings, from the clinics to our OR’s, to our med-surg units. Our ERAS journey is a testament to the teamwork and innovative spirit of Kaiser Permanente Northern California (KPNC).
The ERAS Steering Committee developed and implemented the original 2 ERAS pathways in 2014, which introduced standardized ERAS care components to our colorectal and hip fracture programs. ERAS leveraged strong multi-disciplinary clinical and operational leadership as part of the program’s spread. Each medical center was assigned an ERAS RN mentor to foster communication between regional and facility teams, facilitate rapid cycle change, and enable “barrier busting” achievement. ERAS pathways were subsequently developed for 5 additional surgical procedures. The Northern California ERAS received the Kaiser Permanente David M. Lawrence Patient Safety in 2016.
In 2017, the KPNC ERAS team introduced the ERAS Common Pathway, a streamlined ERAS pathway that could be applied “universally” to patients in 17 different surgical specialties. As noted by Dr. Derrick Lee, KPNC ERAS Physician Clinical Lead, “The ERAS Common Pathway represents an extraordinary collaboration among nurses, surgeons, anesthesiologists, and clinical staff, that puts the patient at the center and enables us to provide ERAS care at the highest levels of reliability and coordination.” (Diagram 1)
Instead of traditional surgical care, where 1 in 4 patients had complications after inpatient surgery, the KPNC ERAS common pathway has realized significant improvements in outcome and patient experience.
Today, roughly 150,000 patients a year receive ERAS care in one of our 21 medical centers, and the program celebrated its 10-year anniversary in 2024. Continued maintenance and basic support of the ERAS program will be necessary to sustain the benefits of faster recovery with fewer complications for our patients.
.