In this episode of The Cardiac Recovery Room, moderator Vicki Morton, Director of Clinical and Quality Outcomes at Providence Anesthesiology Associates in North Carolina, USA, spoke with Alexander Gregory, a cardiovascular anesthesiologist and assistant professor in the Department of Anesthesiology, Perioperative and Pain Medicine, and the Libin Cardiovascular Institute at the Cumming School of Medicine, University of Calgary, Canada, and Dr. V. Seenu Reddy, a cardiothoracic surgeon at HCA’s TriStar Cardiovascular Surgery in Nashville, Tennesee, USA, about the 10 things they hate about Enhanced Recovery After Surgery (ERAS).  

Chapters

00:00 Introduction 

01:38 Overcomplication 

05:29 Simple Barriers 

08:54 Change Obstructionists 

10:52 Status Quo 

12:49 Messing with Protocol 

14:21 Giving Up on Protocol 

16:48 Need for Patient-Reported Outcomes 

19:18 Struggle Into Cardiac Subspecialty 

21:30 Takeaways 

The goal of this discussion was to identify specific challenges and propose potential solutions. They emphasize the importance of having two leaders—a champion and a co-champion—to effectively guide ERAS initiatives. Additionally, they discuss creating standing orders and issues related to microbarriers and resistance to change. They also highlight the need for customization of protocols, acknowledging the differences between surgeons who utilize ERAS and those who do not, as well as the tendency to maintain the status quo. Patient perspectives are another key focus, with a call to implement changes that enhance tracking and monitoring of patient outcomes. Furthermore, they explore the role of technology designed for patients, as well as applying ERAS principles to surgeries that fall “outside of the box.”  

The Cardiac Recovery Room is the place to hear the conversations colleagues are having after the meetings. Each month, a new episode will be released featuring a leadership panel from the ERAS Cardiac Society. 

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