46th Annual Scientific Meeting

20/20 Vision
Embracing innovation that builds on past success

July 9 - 12, 2020 | Virtual

PG Course 2
Sunday, July 12, 2020 | 10:00 am - 2:00 pm ET

Enhanced Recovery After Surgery: Overcoming Barriers to Implementation 

Course Chair: Mikio Nihira, MD

Course Faculty:
Anoushka Afonso, MD, Rajiv Gala, MD and Adam Steinberg, DO

Course Description:
In spite of the well-known benefits of enhanced recovery after surgery programs (EP) such as hastened patient recovery, reduced institutional costs and increased patient satisfaction, implementation of these programs has been inconsistent. The most commonly cited barriers to adoption of an EP relate to time and personnel restrictions required to develop local guidelines, limited hospital/institutional resources (financial, staffing, space restrictions, and education), resistance from other members of the perioperative team, necessity of engagement of the perioperative team, lack of knowledge about the benefits of specific interventions in the program, perceptions about patients’ social and cultural values, and institutional barriers. Institutional barriers such as lack of nursing staff and lack of financial resources from the hospital are frequently cited as barriers. This course will employ the expertise of the faculty to identify evidenced-based strategies (when available) or expert experience to overcome barriers and identifying local enablers that may be used to effectively implement an EP. 

Learning Objectives:
At the conclusion of this activity, the participant should be able to:

  1. Review available tools such as the ACS and ERAS society of the US re: evidence-based ERAS recommendations in GYN to be employed 
  2. Identify how individuals have overcome barriers to implementation at their institutions such as A.Minimizing patient dehydration/collaborating with Anesthesia B.Optimizing multimodal intraoperative/postoperative analgesia / minimizing opioids – collaborating with Anesthesia and Nursing 
  3. Defining patient expectations in advance of procedures A.Reviewing available patient education materials such as the ACS pamphlet and the materials from the NHS B.Focusing patients’ attention upon functional performance rather than pain relief.

Click HERE for Agenda


10:05 am – 10:20 am Faculty and Attendee Introductions and Poll Everywhere Education – Mikio Nihira, MD 

10:21 am – 10:30 am ACS GYN Related ERAS Recommendations – Mikio Nihira, MD

10:31 am – 10:50 am Implementing ERAS as a Single Surgeon at a Community Hospital – Mikio Nihira, MA

10:51 am – 11:20 am Implementing (and overcoming barriers) ERAS at a Large Academic Medical Center – Anoushka Afonso, MD

11:21 am – 11:50 am Contrast Implementing ERAS in a Private Practice/moderate Sized Institution – Rajiv Gala, MD

11:51 am – 12:20 pm Managing Change – Negotiating with stakeholders – Adam Steinberg, DO

12:21 pm – 12:31 pm Break

12:32 pm – 2:00 pm Cases of Implementation Barrier/Panel Discussions – All Faculty

 Supported by an educational grant from Pacira Pharmaceuticals, Inc