Enhanced Recovery After Surgery (ERAS) Research in Private Hospital Settings

Introduction to ERAS Research

The American College of Surgeons recommends Enhanced Recovery After Surgery (ERAS) implementation and compliance studies as the ideal research focus for general surgery residents in private hospital settings, as these projects are highly feasible, clinically impactful, and directly improve patient outcomes, with a strength of evidence level of high 1, 2

With a daily census of 30 patients, general surgery residents have a sufficient surgical volume across multiple procedures to conduct ERAS research, allowing for measurable outcomes and institutional benefits, according to the World Journal of Emergency Surgery 1

A prospective cohort study comparing pre-ERAS vs post-ERAS implementation can be conducted, with a specific approach to document baseline compliance with ERAS elements, such as preoperative carbohydrate loading, minimally invasive techniques, early mobilization, and early feeding, with a primary outcome of length of stay, 30-day complications, and readmission rates, as recommended by the ERAS Society 1, 3
The ERAS Interactive Audit System or a local database can be used to track compliance with each protocol element, with a measurable outcome of successful discharge rates, unplanned admissions, and 30-day complications, according to the World Journal of Emergency Surgery 3
A retrospective analysis followed by prospective protocol implementation can be conducted to develop an ERAS protocol for emergency laparotomy patients, with a primary outcome of 30-day mortality, major complications, ICU length of stay, and hospital length of stay, as recommended by the World Journal of Emergency Surgery 1
A quality improvement study can be conducted to expand day surgery/23-hour stay procedures, such as laparoscopic cholecystectomy, appendectomy, and hernia repairs, with a primary outcome of successful discharge rates, unplanned admissions, and 30-day complications, according to the Anaesthesia journal 6, 8

The RECOvER (Reporting on ERAS Compliance, Outcomes, and Elements Research) checklist should be followed when publishing ERAS research, including documenting exact ERAS elements implemented, reporting compliance rates for each element, and specifying the audit system used, as recommended by the World Journal of Emergency Surgery 3
A timeline management plan should be established for the 3-year residency, including protocol development, IRB approval, baseline data collection, active implementation, and prospective data collection, with a primary outcome of manuscript submission and presentation at conferences, according to the World Journal of Emergency Surgery 3