The concept of Enhanced Recovery after Surgery (ERAS) was introduced by Henrik Kehlet in the 1990’s, using multimodal methods in his ‘fast track surgery’. Professor Kehlet’s theory was adopted and expanded, leading to the modern day ERAS programme.

The ERAS programme involves a multidisciplinary taskforce, of which the patient is central. The programme looks at optimising the patient in 4 stages, pre-operatively, intraoperative, immediate post-operative care and mobilisation and pre-discharge preparation. It requires a change of mind set of traditional beliefs and practice including the ‘sick role’, reduced fasting interval, early re-feeding and mobilisation. Optimising patient’s preparation for the operation and post-operative care, leads to better recovery and surgical outcomes, and ultimately shorter hospital stay.

Shorter hospital stay as a result of ERAS is a much welcomed secondary gain as the worldwide problem of hospital bed shortages escalates due to our ageing population. Shorter post-operative hospital stay also helps reduce the prevalence of hospital acquired infections.

We should be looking to adopt ERAS programme, which is manageable within the hospital resources, to improve outcome for patients and the hospital. Ultimately, as the patients recover better and faster, there is also a secondary gain of a happier work environment.