Hysterectomy is a common surgical procedure that has a post-operative complication rate of 20%. Enhanced Recovery After Surgery (ERAS) protocols reduce complications, hospital length of stay, and healthcare costs for patients undergoing hysterectomy. Compliance is crucial for ERAS success but challenging to achieve in clinical practice. The impact of ERAS protocol compliance on hospital length of stay is unclear for hysterectomy patients at the Canberra Hospital.

The aim of this study is to investigate the effect of compliance with the ERAS protocol on hospital length of stay for patients undergoing elective hysterectomy. 

This prospective cohort study recruited 160 hysterectomy patients since February 2021. Compliance is measured as the percentage adherence to 15 key ERAS protocol elements, with a targeted average monthly compliance of ≥80%. Hospital length of stay is the difference between actual and predicted length of stay in days, as calculated by the American College of Surgeons Surgical Risk Calculator.

Protocol compliance ranged from 46% to 100%, with a mean of 77% (SD 10.55%), which includes the targeted average monthly compliance of ≥80%. The mean difference between actual and predicted length of stay was 0.97 days (SD 1.37). Pearson’s correlation coefficient showed a weak but significant correlation between increased ERAS protocol compliance and reduced hospital length of stay (r= -0.16, p= 0.027).

This study emphasises that ERAS protocol compliance is crucial for optimising the care of patients undergoing hysterectomy at the Canberra Hospital. 

This research paves the way for targeted studies to identify potential barriers to protocol adherence and interventions to increase compliance.


Sanduni Pathiratna1, Kimberly McNeice2, Craig Boutlis3, Andrew Deacon4
 
 

1.     Critical Care Senior Resident Medical Officer, Canberra Health Services, Garran, ACT, 2605

2.     ERAS Nursing Coordinator, Canberra Health Services, Garran, ACT, 2605

3.     Department of Infectious Diseases, Calvary Public Hospital, Bruce, ACT, 2617 

4.     Department of Anaesthesia, Perioperative Medicine and Pain Management, Canberra Health Services, Garran, ACT, 2605