Background Enhanced Recovery (ER) is a new approach to elective surgery with the primary focus being on improving patient outcomes. The basis is that patients are prepared to be in the best possible condition before treatment, have personalised care during their operation, and experience optimal post-operative rehabilitation. This means ‘Getting Better Sooner’ with the mutual benefit of less time in hospital – good for the patient and good for the system. The NHS in England has produced information to empower patients – including people having total joint replacements – to play an active part in ER. This patient information has been drawn from recent and relevant patient experience. In England, 63,000 patients benefit from hip replacement surgery and 69,000 patients from knee replacement surgery per annum.
Objectives To improve patient experience by supporting patients to be better prepared and feel more confident about playing their role in their surgery, from pre admission through to recovery at home.
Methods The Enhanced Recovery Partnership Advisory Board commissioned a patient experience working group, led by its patient and public advisor. It comprised patients with recent experience of ER; myself as a patient representative drawing on my experience of working at Arthritis Care, a user-led organisation; and professionals from NHS Improvement already engaged in patient-focused communications regarding ER. Draft materials were tested with several dozen patients who had recent experience of ER at a specifically commissioned ‘tea party’ event. Feedback from patients and their carers informed the final version.
Results A patient leaflet and film material have been developed and were launched by the England Minister for Health at the Enhanced Recovery Summit in 2012 to an audience of over 500. The leaflet was promoted to 147 healthcare trusts for practical application in the UK. Post-launch evaluation has been carried out with patients and health professionals to assess the value of the material. Early results show:
- 55,000 leaflets were ordered by health professionals within 3 weeks of the Summit launch and 100,000 leaflets distributed to date
- 100% of patients surveyed said the leaflet helped them to feel more confident in their role and responsibilities and ‘getting better sooner’
- 71% were given the leaflet in the pre-op assessment clinic
- 82% received their leaflet from a nurse
- 33 hospital units gave responses to the evaluation survey
- 41% of units worked in orthopaedics
- 93% said they would continue to use the leaflet with patients
‘It was very comforting to know what was expected of me each day and to think that I could manage it too.’ Patient
‘Patients have a better understanding of their need to engage in their own roles and responsibilities. It has prompted them to ask more questions.’ Health Professional
Conclusions The leaflet has helped patients going through an Enhanced Recovery pathway have a more positive experience of surgery by feeling more confident, and by understanding their roles and responsibilities. Those practising Enhanced Recovery are beginning to introduce the new leaflet to patients to add value to their own local material. By having better informed patients, who are well placed to prepare for their operation and recovery more quickly, patient experience will improve – with added benefits such as reduced length of stay in hospital.
Disclosure of Interest None Declared