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Multidisciplinary team working to implement Enhanced Recovery

Angie Balfour Enhanced Recovery Nurse Specialist at NHS Lothian spoke at today’s Enhanced Recovery conference on:

•    Improving multidisciplinary team working
•    Overcoming the challenges and issues

In her presentation Angie talked about the importance of including a patient within the framework of a multi-disciplinary team to implement Enhanced Recovery.
"There are many roadblocks to successful implementation of enhanced recover, patient education, care pathways, compliance, HDU use, discharge, data and sustainability."
"My recommendation is to design a multi-disciplinary care pathway with all members of the team involved.
It must however remember patient centred and take into account all the available skills and expertise of the team."
"We must audit what we're doing, because without data, we really have no idea if what we are doing is working."

Angie's full presentation is available for download at the end of this page.

Angie qualified as a trained nurse in 1994 and started her career as an agency nursing working across Fife and Edinburgh in various clinical areas. Prior to her involvement in the Enhanced Recovery After Surgery (ERAS) programme in 2004, her background was in acute medical admissions and critical care areas including ICU and Surgical HDU. It was here that she was introduced to the ERAS programme and an opportunity arose that allowed her to become the ERAS Nurse working with Professor Fearon who is a founding member of the ERAS Society. This role allowed her to run a clinical research programme whilst having first hand interaction with post op patients encouraging them to adhere to the ERAS protocols and allow for their earlier recovery and discharge from hospital.

Over the last 10 years, ERAS has seen some significant changes – some positive and some not quite so positive. Angie’s involvement in ERAS has been largely clinically based but more recently, she has been moved from her role in Colorectal and tasked with assisting ERAS implementation and roll out across other surgical services throughout NHS Lothian. Clinical teams now realise that ERAS principles can be applied to all elective procedure but there are ERAS elements that can also be applied to the emergency/ trauma pathway. For example – we are in the process of introducing CHO loading to the fractured neck of femur pathway to allow patients to be “fed” and hydrated better prior to their unscheduled operation.

Angie has also been involved with the ERAS Roll-out in Scotland and attends the Scottish Govt. ERAS Co-ordinator meetings regularly. She has also recently set up a Scottish ERAS Nurse Forum to discuss issues such as compliance to the pathway/ the role of the ERAS Nurse and other key issues that can be discussed and supported by like-minded people trying to implement change in a very challenging NHS environment. 

Future events of interest:

British Association of Day Surgery Conference: Quality in Day Surgery
Thursday 20 November 2014 
ICO Conference Centre, London

National PROMs Summit 2014
Wednesday 3 December 2014 
Hallam Conference Centre, London

Measuring and Monitoring Quality
Tuesday 20 January 
ICO Conference Centre, London

Download: Angie Balfour full presentation

2 October 2014


    Partner Organisations

    The Tavistock and Portman NHS Foundation TrustInPracticeClinical Audit Support CentrePlayoutJust For Nurses
    GGI (Good Governance Institute) accredited conferences CPD Member BADS (British Association of Day Surgery) accredited conferences