Provider Resources

Enhanced Recovery After Surgery (ERAS)

Welcome to the MSSIC ERAS toolkit.  Enhanced Recovery After Surgery (ERAS) protocols reduce postoperative complications, hospital length of stay and overall healthcare costs.  ERAS positively influences patient subjective well-being and put the patient at the center of perioperative management and recovery.  In 2019, MSSIC’s interest in pursuing ERAS as a collaborative-wide initiative piqued and making ERAS a standard of care for every MSSIC site would be necessary to facilitate the maximum clinical and financial gains.

The MSSIC Coordinating Center has created this ERAS toolkit which contains numerous resources, patient education, publications, example protocols and risk assessment tools to support our participating sites.  We have also created a “MSSIC ERAS Patient Video” for sites to incorporate into their pre-surgical patient education.

During Phase I, sites demonstrate multidisciplinary team engagement towards the development of ERAS.  They also document their entire ERAS protocol on the MSSIC ERAS template as well as the standardized process for implementing them.  Additionally, all supporting documents such as patient education, order sets, and risk assessment tools are submitted for review and approval.  Phase 2 of MSSIC ERAS includes the tracking of implementation compliance so that processes can be evaluated and adjusted where needed.  Also, the enhancement of risk assessment and optimization occurs by requiring these key risk assessments with optimization be in place: smoking cessation, glycemic control, opioid risk assessment, and optimization of anemia and/or nutritional assessment.

While the MSSIC ERAS Protocol guideline outlines both required and suggested elements, sites are encouraged to assess the current state at their institution and take into consideration their unique patient population and unique site culture when developing an ERAS protocol. Our hope is that the following tools and resources will assist you in that process.

MSSIC sites have positively impacted the standard of care for spine surgery patients and made remarkable strides with ERAS.  As a result, members of the MSSIC Coordinating Center were interviewed by the ERAS-USA organization.  It is currently live on the ERAS-USA website, and we are excited to share it with you (ERAS- interview with MSSIC).  The hard work and commitment to quality improvement at our MSSIC sites makes this level of success possible.  Individually, we can take steps to improve the standard of care for our local spine surgery patients.  However, together, we are transforming how spine surgery patients are cared for across the state of Michigan and now, nationally.

Screening Tools & ERAS Resources

The following resources are examples of screening tools that can identify risks and interventions to better optimize patients before spine surgery. Included are MSSIC Risk Assessments, Smoking Cessation Best Practice Guidelines, the American College of Surgeon’s “Strong for Surgery” program, and the American Society of Enhanced Recovery (ASER) implementation guide.  There are also articles describing the screening tools and interventions implemented by Cleveland Clinic and tools to screen for Frailty.

Strong for Surgery Program

Strong for Surgery empowers hospitals and clinics to integrate checklists into the preoperative phase of clinical practice for elective operations. The checklists are used to screen patients for potential risk factors that can lead to surgical complications, and to provide appropriate interventions to ensure better surgical outcomes. A patient’s risk of negative outcomes from an operation is often both predetermined and modifiable before entering the operating room. Preoperative checklists serve as a communication tool for patients and clinicians to consider common risk areas.

The Strong for Surgery tools are free to surgeons and hospitals.  You may choose to use the entire program or only pieces.  The current tools are attached below.  Under the Provider Resources is a comprehensive implementation guide detailing how to successfully implement the tools.

Contact the Strong for Surgery program at:
Phone: 312-202-5441