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Enhanced Recovery in Gynaecology (Scientific Impact Paper No. 36)

Published: 08/02/2013

This is the first edition of this Scientific Impact Paper.

Update July 2015: New evidence and guidance in this field were reviewed in 2014 and it was decided that revision of this guideline would be deferred to a later date. The version available on the website will remain valid until replaced.

Enhanced recovery (ER), also known as ‘fast track’, ‘rapid’ or ‘accelerated’ recovery, is a model of care for elective surgery patients, originally developed for colorectal patients, that combines elements of care to form a pathway that reduces the physiological stress response and organ dysfunction due to surgery. ER leads to improved patient satisfaction, less variation in the patient care, shorter length of stay in hospital and a reduction in complications and re-admissions.

Thisn paper provides a discussion of ER in gynaecology. It recommends the implementation of ER within gynaecology but recognises this may challenge current traditional practices. This paper also recommends best practice for the multidisciplinary teams involved both pre- and post-surgery, ensuring that the patient is involved at every step of the process from decision to discharge.

The main elements of ER offer safe, high-quality care and should become standard practice for all women undergoing elective gynaecological surgery. The approach offers opportunities to benefit both patients and the NHS through savings from reduced complications and decreased length of stay.

The paper notes that the ER model also offers the opportunity to improve the care of emergency gynaecological admissions. However, implementing ER in obstetrics may be more challenging.