Boost Fitness and Wellness to Boost Surgical Outcomes

Surgery prep isn’t just for the surgical team anymore — patients can take part, too. And it’s more than fasting for eight hours before the procedure, finding a ride home, and stopping certain medications. It’s about prepping the body for the rigors of surgery. It’s about getting in better shape — physically and mentally — to help reduce the risk of complications, shorten the hospital stay, recover more quickly, and promote better outcomes.

Many providers are starting to use preoperative health programs to help surgical patients boost their fitness and wellness to get into the best possible shape before they have their elective procedure.

Dr. Michael Englesbe, a transplant surgeon who started one of these programs at the University of Michigan, was quoted in a recent article in The Washington Post. He said, “The analogy that I usually use is that if you and I were going to run a [5K] race, you wouldn’t do it without preparing — you would prepare, you’d train. A two-hour operation is about as physiologically hard on a patient as running that race.”

In February 2017, the journal Surgery published the results from a study of 641 patients enrolled in Dr. Englesbe’s preoperative health program Michigan Surgical and Health Optimization Program (MSHOP). According to a Healthline.com article, “Getting in Shape for Surgery,” the study found that “basic fitness and wellness coaching beforehand can reduce a surgical patient’s average hospital stay from seven to five days. They also concluded that the pre-surgery regimen reduces medical costs by 30 percent.”

Not Just Working Out

While a patient’s physical fitness is obviously the main concern, it’s not the only area on the “prehab” agenda. This new form of surgery prep takes all aspects of a person’s well-being into account. Preoperative health regimens often include:

  • Movement/exercise — MSHOP patients are told to walk 12 miles a week to prep for surgery
  • Breathing exercises/quitting smoking — strong lungs help reduce the risk of respiratory infections
  • Healthy eating/hydration — Good nutrition and adequate hydration are crucial to health
  • Mental well-being/relaxation — visualization, meditation, guided imagery or prayer

Strong for Surgery

Now, these types of preoperative health programs are almost mainstream. In 2016, the American College of Surgeons (ACS) became the home of Strong for Surgery, a public health campaign and quality improvement initiative originally launched in Washington state in 2012. This program concentrates on using preoperative checklists to engage patients and their surgeons in the discussion of how to prevent several common surgical risks.

Initially, the program focused on the first four risk areas, but this November, Strong for Surgery added four more risk areas to target, bringing the total to these eight:

  • Nutrition
  • Smoking cessation
  • Glycemic control
  • Medication use
  • Delirium
  • Prehabilitation
  • Safe and effective pain control
  • Patient directives

According to the ACS, they are working to expand the program nationwide. “Strong for Surgery will help surgeons play a much greater role in reducing complications, optimizing health for surgery, and recognizing that our job is to help the total health of the patient and the public,” said David Flum, MD, MPH, FACS, professor of surgery and associate chair for research at the University of Washington, Seattle.

Lowering Risks

Preoperative health programs give patients a chance to engage in their health and help mitigate potential surgery risks. It’s an opportunity to put themselves in control and have a hand in promoting the best possible outcome. At BridgeHealth, we also do our part. Our surgery benefit program is focused on reducing patient risk by selecting high-quality providers, verified by external data. With the combination of top-tier surgeons and engaged patients, better health is almost guaranteed.

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