The group won a $1,000 prize for their paper, “Starting Enhanced Recovery After Surgery (ERAS) Spine Program From Scratch at an Academic Institution.”
The USA Health spine team recently won a Best Paper Award at the Safety in Spine Surgery Summit. The group won a $1,000 prize for their paper, “Starting Enhanced Recovery After Surgery (ERAS) Spine Program From Scratch at an Academic Institution.”
Authors of the study were Richard Menger, M.D., M.P.A., chief of complex spine surgery at USA Health and an assistant professor of neurosurgery at the Frederick P. Whiddon College of Medicine; Victor Bowden. M.D., an orthopaedic surgery resident; Stephanie Pentecost, R.N., surgical and procedural quality data coordinator; Leslie Sharbel, C.R.N.P., a nurse practitioner in neurosurgery; and Luke Harris, a third-year medical student who presented their work at the summit.
"This was an outstanding collaborative team effort,” Menger said. “The summit was a great opportunity for our medical student Luke to present at a national meeting, and he did an incredible job. Stephanie deserves a lot of credit for helping our patients receive top-level care and making ERAS happen for spine patients at USA; she is an asset to USA Health."
The aim of ERAS implementation was ensuring spine patients received high-quality care while maximizing outcomes and ensuring patient satisfaction. Objectives included reducing the patients' length of stay, revision rates and time to full recovery. The cohort for this pilot study included 17 patients undergoing outpatient anterior cervical discectomy and fusion (ACDF) procedures. Nine patients received care prior to ERAS implementation, and eight patients were managed with the ERAS protocol.
The protocol consisted of diet modification, elimination of pre-operative NPO status (nothing by mouth) in favor of carbohydrate loading, administration of preoperative gabapentin (a neuroleptic), administration of intraoperative goal-directed fluid therapy, and utilization of total intravenous anesthesia technique. Post-operative guidelines included administration of non-opioid narcotics and optimal return to function through early ambulation and nutrition.
“Reducing length of stay alleviates cost for patients and hospital systems as well as provides beds for other patients in need,” the study concluded. “Given this was a small sample size, future plans include further outcome tracking for ACDF patients as well as expansion of ERAS protocols into other outpatient procedures aimed at improving the quality of care and outcomes for all spine patients.”