Beginning in the surgeonâs office and continued with the preoperative clinic education, the patient and their family are provided with the daily plan for each day of hospitalization. These include milestones to achieve for diet and activities, information about management of pain and drains and the target discharge day if all goes well. These are consistent with the nursing protocols and the medical orders. The consistency reinforces patient autonomy and encourages them to question if the pathway is not proceeding according to what was expected. Patients are encouraged to bring the information with them to hospital. Large posters on the ward can be used to reinforce the information. Patients, nurses and house staff are also aware of discharge criteria. This addresses concerns that ERPs are primarily tools to reduce hospital stay as milestones for recovery need to be met. Patients without complications can reach discharge criteria on POD 2-3 for colon surgery, 3-4 for rectal surgery, POD1-2 for bariatric surgery, and POD 6-7 for esophageal resection.
For more information, see Chapter 16: Hospital Recovery and Full Recovery in The SAGES / ERASÂ® Society Manual of Enhanced Recovery Programs for Gastrointestinal Surgery