Event Blog: ERAS+ Phase 2 Launch

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ERAS+ is designed by medical professionals and uses cutting edge technology to support you through your preparation for, and recovery from major surgery.

We attended the Phase 2 launch event on Monday 3rd September to look at how the project has been developing.

In the first session of the day: ERAS+ GM Perspective, Dr Richard Preece gave us an insight into how ERAS+ is working across Greater Manchester.

Dr Preece discussed his own experiences of being a patient and how when looking at our own recovery, we place a huge amount of focus on getting better. This should be the same for all patients across Greater Manchester.

You wouldn’t run a marathon with no preparation…

We have to bring that back to our own clinical practice and understand what our patients need. This is the start of a journey; a broad set of multiple interventions.

The next session was an ERAS+ Programme Overview led by Dr John Moore.

Dr Moore explained how ERAS+ was focusing on how we get patients better. There are over 4,000 patients across the UK using the ERAS+ programme to help minimise complications after surgery.

With surgery there is a chance to intervene before the actual event, so we should be preparing patients for treatment and support them in their recovery. This could mean back to work sooner, and less readmissions.

Dr Moore identified that we should be getting people out of bed, to understand that pain after surgery is normal, patients should ‘own’ their recovery. We should be empowering patients.

Al Lowe was our next speaker, telling the story of his wife, Sarah Lowe’s, battle with Cancer. Giving a patients perspective really showed the impact ERAS+ can have on patients and their families.

As part of the ERAS+ programme Sarah had access to a full team (physio, dietician, clinical nurse specialist). What made this even more special, was that Sarah felt like part of the team- she was enabled to contribute to her treatment.

That team approach continued throughout treatment. Sarah was able to call up any member of the team to ask for help and advice. That level of interest from the team kept Sarah going; they had an interest in who she is.

Al also talked about the opportunity Sarah was given to talk to other patients who were going through a similar thing; having a supportive atmosphere made Sarah’s journey more positive.

Al concluded by offering suggestions of improvements to the ERAS+ programme. He noted how useful it would be to have spiritual and emotional support considered, clearer boundaries around patient support, and how this programme could be rolled out to other medical interventions.

Dr Gemma Faulkner was up next offering ERAS+ from a surgical perspective. As a surgeon, her main aim is to get the patient through their experience without complications.

Dr Faulkner discussed how over the years we have drifted away from the principles of ERAS, which is why ERAS+ is so vitally important. Missing elements can increase recovery time.

The treatment is not just the operation it is the entire process.

We followed this with six fantastic site updates to hear about how ERAS+ is being implemented. There were updates from MFT Wythenshawe, The Christie, Stepping Hill Hospital, Royal Bolton Hospital, Royal Oldham Hospital and Salford Royal Hospital.

Highlights included:

  • MFT Wythenshawe have had over 300 patients through Surgery School.
  • The Christie have had great patient feedback: “I liked that I could be proactive in my recovery and did everything I could towards achieving that.”
  • Stepping Hill Hospital have aligned their patients goals and nurses goals to ensure everyone is working towards the same thing.
  • Royal Bolton Hospital have introduced ERAS+ branded wristbands for patients so they can be easily identified on the ward.
  • Royal Oldham Hospital are going to be rolling out Surgery School across their two sites from October (rotating every 8 weeks).
  • Salford Royal Hospital have been collecting data over time, and now have detailed and robust data to use.

Simon Wickham, Royal Bolton Hospital, and Tom Osbourne, MFT Wythenshawe, led our next session looking at collecting data throughout ERAS+.

They identified recruitment challenges when collecting data: short lead times for cancer patients meaning they miss Surgery School, often a large number of surgical patients, and different pathways across different specialities meaning patients follow different paths.

However, despite these challenges, both sites have been able to implement changes informed by data collection.

Royal Bolton implemented Surgery School, ERAS+ wristbands, ICOUGH prescription stickers and an online system care plan.

MFT Wythenshawe have also implemented ICOUGH prescription stickers, a review of thoracic patient pathway and have just started to use run charts to show the compliance in wards and their improvement.

Next up was our own Kurt Bramfitt, talking about systems and processes.

Kurt explained the system of profound knowledge; and how we can use this to improve our own systems. He explained how we can’t work in silos, as any changes implemented may not work in wider parts of the system- we need to bring it all together.

We started to look at the various processes that all have to work together, to give us a system perfectly designed to give us the ERAS+ 6 must-dos.

Michelle Childs from GM Active explained next about the partnership between ERAS+ and GM Active.

GM Active have 87 leisure and sport facilities across Great Manchester that can work with patients to find the most appropriate pathway. Patricia, who is featured in the video below, explains how the partnership helped her recovery.

Kirsty Rowlinson-Groves then continued this session by explaining the CAN-Move programme: a free 12 week physical activity/exercise programme which is patient led and tailored to their needs.

Our penultimate session was led by Dr Matthew Evison, Respiratory Consultant, GM Lead for Lung Cancer, and Cure programme lead.

Dr Evison tested our knowledge of smoking, and then went on to explain how tobacco addiction is a disease, and should be treated as one. Treating tobacco addition is the single most cost effective life saving intervention provided by the NHS.

Dr Evison then brought this back to ERAS+ to consider whether the information provided to patients through the programme is the most effective. It is important to look at the intervention points and diagnostic pathway.

The final session of the day was a quick overview of the ERAS+ app by Roger Kadama from Desap. A great platform to engage further with ERAS+ patients.

 

With thanks to:

Dr John Moore, Adult Critical Care Clinical Director MFT, National Innovation Accelerator Fellow ERAS+, @mysurgeryandme

Dr Dan Nethercott, Consultant in Anaesthesia and Intensive Care Medicine, Royal Bolton Hospital, @DanNethercott

Dr Richard Preece, Director of Quality/Medicine for Greater Manchester, @drrichardp

Al and Sarah Lowe

Dr Gemma Faulkner, Consultant General and Colorectal Surgeon, Royal Bolton Hospital, @GemmatheSurgeon

MFT Wythenshawe, The Christie, Stepping Hill Hospital, Royal Bolton Hospital, Royal Oldham Hospital, Salford Royal Hospital.

Simon Wickham and Tom Osbourne

Kurt Bramfitt, Assistant Director Haelo

Michelle Childs, Senior Physical Activity Development Officer – Life Leisure

Kirsty Rowlinson-Groves, Active Lifestyles Officer, Can-Move Programme

Dr Matthew Evison, Respiratory Consultant/GM Lead for Lung Cancer, Cure Programme Lead

Roger Kadama, Desap

@GM_ERAS_PLUS @HealthFdn

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