Optimizing Clinical Effectiveness of Enhanced Recovery After Surgery (ERAS): Multidisciplinary Pathways, Patient-Centered Outcomes, and Data-Driven Performance Analytics

Abstract

Enhanced Recovery After Surgery (ERAS) has become a paradigm shifting, evidence based approach to perioperative care, with the goal of helping to mitigate surgical stress, increase functional recovery, and improve clinical outcome in surgical specialties. ERAS pathways have been initially applied to colorectal surgery but are currently also used in standard gastrointestinal, bariatric, thoracic, spine, and minimally invasive surgery. This narrative review summarizes existing evidence about the clinical efficacy of the ERAS, focusing on the multidisciplinary integration, patient-centered outcome measures, psychosocial factors of recovery, workforce, and performance analytics of use of data. The review analyzes the domains of outcomes, the complications, length of stay, pain management, functional recovery, and efficiency of the system, based on the literature related to the field of surgery, anesthetic, public health, and digital health. Two level of analytic tables describe aggregated patient-level and system-level patient effects of ERAS implementation. These results indicate that ERAS is a powerful, scalable, and results-oriented framework of current surgical care, with core issues surrounding equity and implementation fidelity, and data integration.

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