About Enhanced Recovery Canada

Helping patients feel better and get home quicker after surgery is vital, especially given the pressures facing our healthcare system. Enhanced Recovery Canada™  (ERC) surgical pathways and patient resources reduce complications and support shorter hospital stays and safer transitions after surgery.

Led by Healthcare Excellence Canada and partners, ERC was formed in 2017 to lead the drive to improve surgical safety across the country. This evidence-informed approach to surgical care is aimed at minimizing the stress of surgery and supporting patients to recover more quickly.

Meet the Board of Directors

Position statement

ERC was originally a project supported the Canadian Patient Safety Institute, under the guidance of its board of directors. In 2021, the Canadian Patient Safety Institute amalgamated with the Canadian Foundation for Healthcare Improvement to form Healthcare Excellence Canada.

Enhanced Recovery After Surgery (ERAS)

ERC’s clinical and patient resources are based on Enhanced Recovery After Surgery (ERAS) surgical best practices. ERAS is a multi-modal approach to recovery pioneered by Danish surgeon Dr. Henrik Kehlet for colonic resections. Generally, traditional surgical pathways tried to improve outcomes by focusing on postoperative care. ERAS® provides guidance for how to care for the patient before and during surgery as well, because this care impacts postoperative recovery.

The ERAS Society provides pathways for a number of specialties. In Canada, surgical pathway tools and patient resources are available to support the most frequent surgeries that occur in every operating room across the country, including colorectal, gynaecologic, inpatient and outpatient orthopaedic hip and knee replacements, and c-section surgery.

These evidence-informed principles support better outcomes for surgical patients including: an improved patient experience, reduced length of stay, decreased complication rates and fewer hospital readmissions.

Six core ERAS principles

Enhanced Recovery Canada’s clinical pathways and resources have been developed based on six core ERAS principles:

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)

These represent a paradigm shift in how patient care is planned, delivered and monitored. The ERAS approach re-examines traditional practices, replacing them with evidence-informed best practices when necessary. For example:

• ERAS best practices encourage stopping solid food for up to eight hours and enabling clear fluids for two hours before surgery. This challenges historical surgical practices of nothing by mouth after midnight on the day of surgery.
• Traditionally, patients may feel the need to stay in bed to recover from surgery. Best practices, however, promote early mobilization, having patients up and moving as soon as possible after surgery.

Additional Resources

The following information will help you implement ERC at your site.

• download A Guide to Patient Safety Improvement
• view and use this ERC infographic