Role of Adherence to Enhanced Recovery After Surgery Programs in Mitigating Health Care Disparities

JAMA Surgery ◽  
2020 ◽  
Vol 155 (1) ◽  
pp. 91 ◽  
Author(s):  
Olga Rozental ◽  
Robert S. White ◽  
Roniel Weinberg
2019 ◽  
Vol 51 (1) ◽  
pp. 22-30 ◽  
Author(s):  
Diana Wu ◽  
Lamercie Saint-Hilaire ◽  
Andrew Pineda ◽  
Danielle Hessler ◽  
George W. Saba ◽  
...  

Background and Objectives: Health professionals increasingly recognize the role that social determinants play in health disparities. However, little focus is placed on how health care professionals themselves contribute to disparities through biased care. We have developed a curriculum based on an antioppression framework which encourages health professionals to evaluate their biases and combat health care disparities through an active process of allyship. Methods: Teaching methods emphasize skill building and include lectures, guided reflections, and facilitated discussions. Pre- and postsurveys were administered to assess participants’ confidence level to recognize unconscious bias and to be an ally to colleagues, patients, and staff. In total, we conducted 20 workshops with a total of 468 participants across multiple disciplines. Results: The survey response rate was 80%. Using a paired t-test, the mean difference in the pre- and postsurveys revealed a statistically significant improvement across all measures. Participants showed the greatest improvements (large effect size d>0.8) in their understanding of the process of allyship, their ability to describe strategies to address, assess, and recognize unconscious bias, and their knowledge of managing situations in which prejudice, power, and privilege are involved. Conclusions: Results show that an antioppression curriculum can enhance health professionals’ confidence in addressing bias in health care through allyship. For those who value social justice and equity, moving from the role of bystander to a place of awareness and solidarity allows for one’s behaviors to mirror these values. Allyship is an accessible tool that all health professionals can use in order to facilitate this process.


2020 ◽  
Vol 52 (2) ◽  
pp. 154-164
Author(s):  
Alan Kaye ◽  
Jordan Renschler ◽  
Kelsey Cramer ◽  
Kendall Klein ◽  
Amanda Granier ◽  
...  

2019 ◽  
Vol 31 ◽  
pp. 116
Author(s):  
C. Wai Wing ◽  
F.T. Yim Kwan ◽  
T. Chung Yan ◽  
A.T. Tat Kwong ◽  
W. Wing Shu ◽  
...  

2019 ◽  
Vol 6 (2) ◽  
pp. 205510291986063
Author(s):  
Eleanor Phillips ◽  
Stephanie Archer ◽  
Jane Montague ◽  
Anish Bali

There is little qualitative research exploring non-cancer gynaecology patients’ experiences of enhanced recovery after surgery (ERAS) protocols. Seven women participated in audio-recorded interviews, discussing their experiences of enhanced recovery after surgery for gynaecological surgery. Data were transcribed and analysed using interpretative phenomenological analysis. Three themes were identified: meeting informational needs, taking control of pain, and mobilising when feeling fragile. Control emerged as a key element throughout the themes and was supported by provision of factual information. While participants were generally satisfied with their experience, topics such as concerns about analgesic use, the informal role of staff in mobilisation, and the expressed desire for more experiential information for participants require further research.


Author(s):  
Timothy Furnish ◽  
Engy Said

The chapter “New Vistas in Perioperative Pain Management” provides an overview of analgesics for acute pain that have been recently introduced and that are in development as well as a discussion of enhanced recovery after surgery (ERAS) programs that make use of multimodal analgesic regimens. It reviews the innovation in analgesics that has focused on new formulations and uses of older compounds including oral, intravenous, and transmucosal agents. It describes the potential role of mu-opioid g-protein modulators as novel opioids with an improved adverse effect profile as well as a novel opioid with the potential for lower abuse potential. It also explains the use of analgesic regimens and pathways in ERAS programs to reduce recovery times and length of hospital stays.


Medical Care ◽  
2017 ◽  
Vol 55 ◽  
pp. S4-S5
Author(s):  
Baligh R. Yehia ◽  
Clinton L. Greenstone ◽  
Christina B. Hosenfeld ◽  
Kameron L. Matthews ◽  
Laurie C. Zephyrin

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