Program overview :

Resources for Healthcare Providers and Leaders

Enhanced Recovery Canada’s™ (ERC) clinical pathways offer healthcare providers in Canada evidence-informed strategies to improve outcomes in patients undergoing common surgeries.

Based on best practices that put the quadruple aim within reach, these pathways promote a multidisciplinary team approach focused on all areas of the patient’s journey. If implemented consistently, these strategies improve patient experience and reduce length of stay, complication rates and hospital readmissions – all valuable outcomes at a time when healthcare systems are under serious pressure.

Clinical pathways

The following clinical pathways have been developed for surgeons, anaesthesiologists, nurses, dietitians, physiotherapists and other healthcare providers involved in delivering surgical care, as well as healthcare leaders and policy makers.

Gynecologic surgery resource

Applies to adult patients undergoing scheduled benign or malignant gynecology surgery performed with either open or minimally invasive routes (vaginal, laparoscopic, or robotic). All healthcare professionals involved in the care of elective gynecologic surgery patients should be familiar with the ERC clinical pathway for gynecologic surgery.

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Orthopaedic surgery resource

Covers inpatient and outpatient hip and knee joint replacement surgeries. All adult patients who require total hip arthroplasty (THA) or total knee arthroplasty (TKA), or unicompartmental arthroplasty (UKA) should be considered, regardless of the planned hospital length of stay (outpatient or hospitalized).

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Colorectal surgery resource

Applicable for patients undergoing elective colorectal (also known as bowel or colon) surgery.

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Cesarean delivery resource

All pregnant people who require cesarean delivery should be considered for enhanced recovery after surgery management using the recommendations provided in this clinical pathway, including patients undergoing elective and unplanned urgent or emergent surgeries.

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Clinical pathways are complemented by patient resources, including guidebooks and animated resources, that engage patients and their caregivers on the path towards enhanced recovery.

Principles behind enhanced recovery best practices

The clinical pathways are based on six Enhanced Recovery After Surgery (ERAS) principles applicable to all surgeries. These include:

  1. patient and family engagement
  2. nutrition management
  3. fluid and hydration management
  4. early mobility and physical activity
  5. surgical best practices
  6. pain management with fewer narcotics (multi-modal opioid-sparing analgesia)

Pathways are organized in a stepwise approach according to patients’ continuum of care. Patient education and patient optimization are presented outside of the traditional pre-, intra-, and post-surgical timeline to emphasize the importance of adequately preparing patients for surgery. The pathways also includes variables for clinical audit and quality improvement purposes.

Learn more about ERC and the ERAS approach.

Additional Resources