Roadmap to the Enhanced Thoracic Surgical Journey

The Enhanced Recovery Program (ERP) is a comprehensive, multidisciplinary approach that directly impacts the functional recovery and quality of life of patients after surgery. Initiated in 2013 at The University of Texas MD Anderson Cancer Center by the Liver Surgery group and expanded to numerous specialties, the Thoracic and Cardiovascular Surgery Department developed a version of Enhanced Recovery After Thoracic Surgery in 2014. The benefits gained thus far include (1) decreased postoperative complications, (2) reduced hospital length of stay, (3) decreased opioid usage, (4) decreased healthcare costs, and (5) improved patient satisfaction. This article aims to provide a brief description of the history of the enhanced recovery approach and to identify the critical elements of the program necessary for improved patient care. It is intended to serve as a practical guide for program implementation in thoracic surgery departments at other institutions.