MUHC Surgery Recovery Program supporting you through arrival to discharge

Imagine you have a surgery scheduled for next week. On the one hand, you are extremely happy that you are on the right path to getting better. On the other hand, you’re not quite sure how it will feel, how difficult you will find the recuperation period, and what, if anything, you need to do to prepare for your hospital stay.

Thanks to the MUHC Surgery Recovery Program, also known as PRETSURE, you can set these types of worries aside. From your arrival to discharge from the hospital, PRETSURE will make sure you get through your procedure as smoothly and as successfully as possible.

Dr. Liane Feldman, director of the Section of Minimally Invasive Surgery at the McGill University Health Centre (MUHC), “I was looking for a way to enhance patient recovery after surgery, get evidence into practice and better coordinate surgical care when the Surgery Recovery Program (PRETSURE) pilot project was launched in 2008,” says Dr. Liane Feldman.  “Today, PRETSURE is an official MUHC program and is composed of 12 members including anaesthesiologists, surgeons, managers, physiotherapists, nutritionists, pharmacists, an associate director of nursing, nurse educator, patient flow coordinator and more.”

Thanks to PRETSURE, quality of care has already shown signs of improvement on all levels. For example, when medical orders are implemented for a surgical procedure, all the surgeons involved have already reached consensus and approved them, which decreases variability and standardizes practices. Another tool used in this program is the creation and distribution of patient education booklets at the preoperative appointment. In these booklets patients learn, through words and pictures, all the information about their procedure. This includes the steps the patient will go through from arrival to discharge from the hospital.

“The patients and their families now arrive prepared at the hospital,” says Debbie Watson, a nurse clinician and coordinator for the MUHC PRETSURE program. “They know what will happen to them and what they need to do, which is very reassuring and empowering for them.”

Length-of-stay has also decreased. For esophagectomy, one of the most complex procedures in digestive surgery, the average length of stay was 19 days, but since the implementation of the pathways, 60 per cent of patients were discharged home within 8 days of the operation.

The ultimate goal is to develop the program for the 20 most prevalent surgeries at the Montreal General Hospital of the MUHC, such as hip and knee arthroplasties, thyroidectomy and radical cystectomy, to name a few.