The average hospital stay among women after a cesarean section is about four days. A new initiative at Saint Peter’s University Hospital in New Brunswick aims to reduce that to two.
In November 2016, the hospital implemented the Enhanced Recovery After Surgery (ERAS) model to accelerate recovery time for c-section patients. The program is targeted at women undergoing elective c-sections (including repeat c-sections). Through an app called SeamlessMD, doctors engage patients with reminders, tasks, education and daily milestone tracking. Women begin using the app at least four weeks before their scheduled delivery and continue using it when they return home.
One of the initiative’s goals is to reduce use of prescription opioids after surgery. “We write 260 million narcotic prescriptions in this country every year,” says Dr. Attila Kett, chair of the department of anesthesia at Saint Peter’s, and the physician who introduced ERAS at the hospital. “We’re trying to reduce in-hospital narcotic use because it corresponds with home narcotic use. If you use less in the hospital, you need less at home.”
In the hospital, women are urged to get on their feet just six hours after surgery, and non-narcotic pain medication is encouraged. Once patients are discharged, doctors monitor their medication use through the app.
The ERAS model originated in England in 2012. The program at Saint Peter’s is among the first of its kind in the United States. The hospital is already seeing results. Over the past year, patients who have used SeamlessMD have cut their stay by one and a half days.
“Obviously the goal is to have less c-sections, but in certain cases they are required,” says Kett. “Our goal is to make women who do need them more comfortable and knowledgeable.”