Implementing ERAS to improve head and neck surgery outcomes

April 23, 2024

The paradigm shift to incorporate Enhanced Recovery After Surgery (ERAS) protocols into practice has been widely accepted by many surgical specialties, including otolaryngology.

Head and neck surgeons at Mayo Clinic in Jacksonville, Florida, have implemented an otolaryngology-specific ERAS model with the goals of increasing patient satisfaction and decreasing complications.

Adult patients who have undergone or were scheduled to undergo free tissue transfer reconstruction procedures were admitted to the SICU until May 2023. At that time, the protocol changed to admit these patients to the surgical floor following a brief stay in the postanesthesia care unit.

Preliminary results indicate the new ERAS protocol is associated with improvements for all major care metrics, including a 9.9% reduction in ED visits and a 6.8% reduction in readmission rates. In addition to improved patient outcomes, it is expected that there will be a significant decrease in length of stay as well as hospital charges, benefitting both patients and payers.

Since implementing the new protocol, Samip Patel, M.D., a Mayo Clinic otolaryngologist in Jacksonville, Florida, notes: "We are observing that patient satisfaction is higher and patients are recovering quicker, reinforcing what we have learned about admitting patients straight to the floor, early mobilization, and being very intentional with both pre- and post-operative care."

Looking ahead, the implications for widespread implementation of the protocol include an expedited return to function and a reduction in postsurgical complications necessitating additional intervention.

"Our team approached the ERAS protocol from a value-based perspective to improve patient satisfaction and quality of care while also reducing costs in the form of length of stay, surgical complications and avoidable readmissions," says Dr. Patel. "ERAS has led to improved, faster recovery to baseline in a way that empowers patients and is good news for everyone."

For more information

Refer a patient to Mayo Clinic.