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CME: National Implementation of Enhanced Recovery in UK and next steps

Activity Description / Statement of Need:

In this online CME self-learning program:


Enhanced recovery after surgery (ERAS) is a multimodal perioperative care pathway designed to attenuate the stress response during a patient’s surgical procedure and preserve organ function while promoting early recovery.  While this approach is not new, it has not always been widely employed in spite of supporting evidence from a range of randomized controlled trials, systematic reviews, and meta-analyses.  This literature suggests that ERAS programs are safe, cost-effective, and minimize the length of stay in a hospital without compromising quality of care. ERAS programs are successful in part because they are proactive in nature, comprised of interventions beginning during preoperative planning and continuing through intraoperative management and postoperative care.


Although the evidence suggests that the multimodal, ERAS approach may be superior to conventional perioperative care, there are a number of challenges to the adoption of ERAS where it is not already used, including: resistance to change, variability between components and compliance to ERAS protocols, and the need for an engaged multidisciplinary team.




  • The UK experience: a crisis of cost
  • Intra-abdominal surgery: morbidity and cost – room for improvement
  • The tenets of enhanced recovery after surgery (ERAS): components and process from referral through discharge and follow up
  • The present gap in care, expressed in length of stay
  • Perioperative fluid management consensus statements and guidelines: ERAS in the context of NICE recommendations; Innovation, Health and Wealth Review; and the British Consensus Guidelines on Intravenous Fluid Therapy for Adult Surgical Patients
  • Perioperative Surgical Home elements


Target Audience:

This program has been designed for a multidisciplinary physician and nurse audience including: ICU / Anesthesia / Peri-op / Intensivists / Trauma / Critical Care

This program is supported by Educational Grants from Edwards Lifesciences.

Release Date: July 03, 2014 -- Expiration Date: July 03, 2016

Faculty: Monty Mythen, MD


Learning Objectives

By the end of the session the participant will be able to:

  • Identify trends and characteristics in contemporary surgery settings that support adoption of an enhanced recovery after surgery (ERAS) program
  • Identify the elements of ERAS
  • Synthesize a hypothetical ERAS program based on the experience of other institutions



Faculty Disclosure and Resolution of COI

 As a provider of continuing medical education, it is the policy of ScientiaCME to ensure balance, independence, objectivity, and scientific rigor in all of its educational activities. In accordance with this policy, faculty and educational planners must disclose any significant relationships with commercial interests whose products or devices may be mentioned in faculty presentations, and any relationships with the commercial supporter of the activity. The intent of this disclosure is to provide the intended audience with information on which they can make their own judgments. Additionally, in the event a conflict of interest (COI) does exist, it is the policy of ScientiaCME to ensure that the COI is resolved in order to ensure the integrity of the CME activity. For this CME activity, any COI has been resolved through  content review ScientiaCME.


Faculty Disclosure: Dr.  Monty Mythen, MD discloses that he is a consultant / speaker for Edwards Lifesciences and Deltex.


Disclosures of Educational Planner: Charles Turck, PharmD is an officer and part owner of ScientiaCME, LLC, which has received a grant from the commercial supporter of this program: Edwards Lifesciences .


Commercial Support Disclosure: This program is supported by an educational grant from Edwards Lifesciences 


  • Read the learning objectives above
  • Take the Pre-Test (optional). Completion of the pre-test will help us evaluate the knowedge gained by participating in this CME activity.
  • View the online activity. You may view this is in more than one session, and may pause or repeat any portion of the presentation if you need to.
  • Take the post-test
  • Complete the activity evaluation and CME registration. A CE certificate will be emailed to you immediately.

Cultural and Linguistic Competence

System Requirements

Windows 7 or above
Internet Explorer 8
*Adobe Acrobat Reader
Mac OS 10.2.8
Safari or Chrome or Firefox
*Adobe Acrobat Reader
Internet Explorer is not supported on the Macintosh

*Required to view Printable PDF Version

Perform Pre-Test (optional)

Please take a few minutes to participate in the optional pre-test. It will help us measure the knowledge gained by participating in this activity.