Anesthesiologist Dr. Kelly Mayson has been working in the area of Enhanced Recovery After Surgery (ERAS) since 2013. ERAS pathways have been created to improve and standardize perioperative care as well as to reduce post-operative complications and length of stay in hospital for patients undergoing colorectal surgery, gynecology oncology, radical cystectomy, and hepatic and pancreatic resections. Potentially modifiable risk factors such as iron deficiency anemia, smoking, under-nutrition, hyperglycemia and frailty are associated with increased morbidity and mortality, and longer hospital stays.
Dr. Mayson is working on a project entitled Pre-operative optimization prior to major oncology surgery as a component of Enhanced Recovery After Surgery program. Identifying high-risk patients and optimizing them in the weeks and months prior to hospitalization for their surgical procedure is the project’s focus. Along with a multi-disciplinary team that includes surgeons, family physicians, endocrinologists, transfusion medicine specialists, perioperative services, nursing staff, patient representatives, dieticians, and physiotherapists, Dr. Mayson has been working for the past year to refine educational materials provided to patients prior to major oncological surgery. The team has also worked on enabling appropriate and easy referrals to the Perioperative Blood Management program, Endocrinology, or Internal Medicine Perioperative Consult Team, physiotherapy for prehabilitation, and/or dieticians for patients as they are on the surgical waitlist.
The Vancouver Physician Staff Association (VPSA) is funding the physicians’ time spent in getting together after hours to work on this project. Additional funding is provided by the Physician Led Quality Improvement program to support Dr. Mayson as the project lead.
“It’s great to have funding from both of these streams,” said Dr. Mayson. “I depend on my multi-disciplinary team and it means a lot to be recognized for work that was so often before simply done off the side of our desks without compensation.”
Patient-centric focus
The multi-disciplinary team that Dr. Mayson leads includes two patient representatives.
“The time after diagnosis and prior to undergoing oncological surgery can be very scary,” she said. “It’s also a very teachable moment to motivate patients to change certain lifestyle habits. Because our goal is to improve patient education, it’s important for patients to truly be involved in our work. Our project began with a survey last summer of postoperative patients on three surgical wards and over the past year we’ve been looking for opportunities to improve our education materials and the flow of information both to patients and to physicians.”