Could ERAS protocols be integrated into the national Standards for Quality in Healthcare in Türkiye?

Abstract

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Dear Editor,

We are writing to propose the integration of Enhanced Recovery After Surgery (ERAS) protocols into the Standards for Quality in Healthcare (SQH; Turkish: Sağlıkta Kalite Standartları) guidelines established by the Ministry of Health of Türkiye. Established in 2003 as part of the Health Transformation Program, the SQH guidelines have served as a comprehensive framework to improve healthcare quality nationwide. Over the years, these standards have evolved to incorporate various dimensions of healthcare delivery. Specifically, the SQH guidelines aim to enhance patient safety, improve the quality of healthcare delivery, and increase efficiency. They outline regulations targeting patient care, medication management, infection prevention, disinfection and sterilization, operating room protocols, and intensive care services. However, while the SQH have significantly advanced healthcare standards, they lack specific, detailed protocols addressing enhanced recovery pathways such as those defined by ERAS.

ERAS constitutes a multidisciplinary strategy designed to accelerate postoperative recovery and enhance patient outcomes through evidence-based practices [1]. The ERAS protocols, originally developed in the late 1990s, have gained global recognition for their success in reducing surgical complications, shortening hospital stays, and improving patient satisfaction. Studies conducted in the United Kingdom demonstrated that ERAS implementation in colorectal surgery reduced the average length of hospital stay by 2–3 days and lowered complication rates by approximately 30% [2]. Similarly, hospitals in Denmark have reported a 20% improvement in patient satisfaction scores following the integration of ERAS into orthopedic surgical care [3]. Moreover, prehabilitation programs emphasize structured exercise and nutritional optimization [4]. However, key elements of ERAS are either insufficiently addressed or absent in the SQH framework. Incorporating ERAS protocols into the SQH framework will significantly enhance postoperative care and patient outcomes while positioning Türkiye as a leader in adopting modern, evidence-based practices.

Below, we present several recommendations for integrating ERAS protocols within the current SQH framework.

In conclusion, incorporating ERAS protocols into the SQH framework will not only enhance the quality of postoperative care but will also elevate Türkiye’s healthcare system to meet international standards. By focusing on evidence-based practices, patient-centered care, and continuous improvement, this integration has the potential to significantly improve patient outcomes and set a benchmark for modern medical advancements in the region. The urgency to act lies in the growing demand for effective, efficient, and patient-focused surgical care. Adopting ERAS protocols within the SQH framework represents a vital step forward in achieving these goals. We thank our readers for considering this proposal for a more integrated approach to postoperative care standards in Türkiye.