Munson Medical Center program preps patients for positive outcomes
Beth Pearce felt like she was borne by a whirlwind after receiving a diagnosis of colon cancer last summer. The Traverse City-area resident’s surgery was scheduled quickly and she started to get overwhelmed – then Loie Rainey, M.S.N., R.N., CNOR from Munson Medical Center’s Enhanced Recovery Program stepped in to help her navigate the journey.
“It was probably the thing that got me through a very scary time,” Pearce said. “I was at the point of overload. They absolutely walked me through it, told me what was going to happen, what my surgery was going to consist of and how it would affect my prognosis.”
Rainey said the underlying principle of the program aims at preparing a patient physically and mentally for surgery so they will recover from it faster and stronger. “We are seeing a decreased length of stay and decreased surgical site infections since implementing the program last spring,” she said.
Colorectal surgical patients face recovery challenges such as surgical site infections, a longer length of stay and the potential for readmission to the hospital after discharge. The Enhanced Recovery Program uses a multi-disciplinary approach to help patients become part of their recovery process – through pre-surgery nutrition, exercise, and education.
The process starts when Munson Medical Center-affiliated surgical offices contact Rainey to enroll colorectal surgical patients in the program. Patients attend a two-hour educational program two to three weeks before surgery to learn about the procedure. They receive a pedometer to track and record their exercise, a spirometer to practice breathing and strengthen their lungs, and a nutritional plan which includes increasing protein input and limiting sugar – which can heighten the potential for an infection.
“This empowers patients to become partners in their care because they know what to expect,” Rainey said.
Twelve hours and again two hours before surgery, non-diabetic patients are asked to up their carb intake with white grape juice. Tylenol is administered to all patients just prior to surgery. The surgery itself is usually minimally invasive using laparoscopy, laparotomy, or a robotic-assisted surgical device. Patients only have open surgery if needed.
There is limited use of gastric tubes through the nose, limited opioid use, early efforts encouraging patients to walk, removal of urine catheters on day one and daily bedside monitoring by the Enhanced Recovery Care Team.
Pearce said her conversations and preparations with Rainey paid off. “I was doing things nutritionally to help me through the process,” she said. “By the time I went in for my surgery I was at ease. When they were prepping me, Loie was right there.”
Following discharge, Rainey contacts the patients within 24 - 48 hours. After that, she reaches out weekly for the first 30 days, and then 60 days and 90 days later to ensure that recovery proves successful.
Pearce believes the Enhanced Recovery Program made the difference in her experience. “It was a pretty amazing program. I heard from Loie once or twice a month until Christmas.”
In annual rankings released in August 2016, U.S. News and World Report characterized Munson Medical Center as high performing in colon cancer surgery. The hospital ranked fifth in quality in the State of Michigan.
Learn more about Munson Medical Center's quality efforts.