We're getting heart surgery patients home sooner
Clinicians at Barts Health NHS Trust are helping to reduce the time patients spend in hospital after heart surgery.
Led by consultant anaesthetist Dr Bonnie Kyle, the Enhanced Recovery after Cardiac Surgery programme has cut the average length of stay at the Barts Heart Centre from eight and a half days to five, saving around 700 bed days since it was established last year.
The ERACS approach, which involves small incremental improvements across the patient journey, from time spent in intensive care to recovering on a ward, was pioneered by medics from the Leipzig Heart Center in Germany.
Patients are carefully selected based on risk factors including their age and overall health.
Around 250 people have gone through the programme so far, at a rate of around 10 per week.
Alongside effective prehabilitation and pre-assessment, reducing the time heart surgery patients spend in hospital is associated with better patient outcomes, improved patient satisfaction and lower costs to the NHS.
Bonnie said: “After a promising start, we hope to expand the programme to more patients and, crucially, more complex patients, who stand to gain the most from the improvements.”
Overall, more than 22,000 patients at Leipzig have benefitted from the ERACS model. It has allowed the Centre to almost double the number of procedures it performs.
After visiting our European partners with the Barts ERACS team last year, Bonnie, who hopes to one day establish a dedicated ERACS intensive care unit and ward, said: “I see no reason why we cannot be on a par with and produce similar outcomes to our colleagues at Leipzig Heart Centre.”
Antonia’s story 
Antonia, a 38 year-old from London, had surgery to replace her mitral valve in December last year. She was told about the ERACS programme during her pre-operative assessment.
She said: “I knew from having a caesarean section that it was important to be up as quickly as possible after surgery, so I was pleased to be offered the support.
“The programme, combined with minimally invasive surgery, meant I was out of bed the day after my op and walking not long after.
“Open heart surgery is a big deal and it can feel daunting to move so soon, but the programme made me feel safe. More importantly, I had a nine month old baby at home and wanted to be reunited as soon as possible.
“I was able to hold my daughter in my lap on day two and be back at home reading her a bedtime story on day four. After three weeks I was able to lift her safely. This was a huge deal for me and made an otherwise quite traumatic experience much easier.
“The sooner you get moving the quicker your body heals and the pain improves. You have so much support in the hospital to make sure you are achieving your milestones each day, and when you go home there is a phone line in place which you call if you have any concerns.”
The ERACS programme was shortlisted for the 2024 WeImprove Awards in the WeImprove Working across Systems category.
Pictured top of page: Antonia six months post-surgery with her baby daughter Callie; bottom of page: Antonia reunited with her daughter in hospital.
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