Abstract

The use of enhanced recovery pathways within elective surgery has increased in recent years but uptake outside of specialist centres is still slow, despite the growing evidence base to support their introduction. This article will briefly outline what is meant by an enhanced recovery pathway (ERP) and outline the central characteristics and features which make up an ERP. The procedural details and results of an orthopaedic ERP which has been used in 2391 consecutive hip and knee joint replacement patients at a NHS district general hospital within the United Kingdom will then be outlined. The results of this unit illustrate that when a standardised, multi-disciplinary pathway is implemented and managed correctly, dramatic reductions to length of stay can be achieved. In combination, high levels of both staff and patient satisfaction are achieved along with good clinical outcomes. It is proposed that if such ways of working are implemented in other hospitals major economic and capacity savings could be realised at the same time as improving patient care.

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