The Effectiveness of the Enhanced Recovery Programme for Category 4 Elective Caesarean Sections within Brighton and Sussex University Hospitals


Elective caesarean sections places a financial burden on the NHS, the Enhanced Recovery Programme (ERP) aims to address this by accelerating patient discharge. It was introduced in Brighton and Sussex University Hospitals (BSUH) in June 2015 and this audit evaluates its effectiveness.
Patients included were those on the ERP in June 2015 and June 2016 and had a category 4 elective caesarean sections at BSUH. Total 72 patients were included. Data was collected from patient notes examining completion, compliance of ERP and outcome measures.
Completion of ERP tasks increased at Royal Sussex County Hospital (RSCH) although overall were higher at Princess Royal Hospital (PRH). Compliance shown by the amount of the proforma completed increased at the RSCH from 37.9% to 55.8% (p<0.001), but decreased at PRH from 69.8% to 51.6% (p<0.001). Outcomes measures including the percentage discharged day 1 decreased at the RSCH and increased at PRH. Complications negligibly increased and there were no cases of readmissions. Breastfeeding decreased at the RSCH from 83.3% to 81% and increased at PRH from 57.1% to 83.3%
The completion and compliance with ERP is poor, although there have been improvements at the RSCH but rates are mostly better at PRH. Outcome measures have not significantly changed, but may be due to the poor ERP uptake.
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