The Story


EBPOM sees the launch of CHEERS DREAM campaign

Our mission is to begin to take steps towards embedding the principles of DREAM … DRinking, EAting and Mobilising into the hearts and minds of patients and healthcare professionals following surgery, expediting good quality recovery and wellness.

It is well known that return of normal gut function, avoidance of prolonged and unnecessary intravenous fluids, and early mobilisation not only aid recovery, but contribute to improved patient-rated experience, satisfaction and reduced incidence of complications.

Traditionally, recovery after surgery was characterized by long hospital stays, an inertia to mobilize and reticence to take down intravenous fluid drips, preventing patients from redressing their own fluid balance with a normal diet and fluid intake.

With the advent of Enhanced Recovery Pathways, much of this has changed. Hospital stays following major surgery are shorter, patients are not fasted excessively preoperatively and bowel prep and its dehydrating effects are avoided. But there is room for improvement. We believe in the importance of putting the patient at the centre of their care, debunking medical jargon terms, and making it explicit what goals they should be striving for before and after their surgery.

All too often healthcare systems focus on evaluating processes, overlooking outcomes. Reducing variation and delivering high quality care must be the common goal of health care professionals and partners in industry. Distraction from these central tenets is common with debate more often focusing on the nuances of competing technologies and reducing the signal-to-noise ratio. In essence, there are always a number of solutions that allow the clinician to “do the right thing” for patients, and fixating on the process rather than the outcome dilutes the impact of our interventions. As such our campaign is specifically technology agnostic, embracing and understanding the raft of choices we as clinicians have available to us. We believe that an outcome and value-based health care system translates to fitter healthier patients and health economics.

We know that inappropriate fluid management in the perioperative period can cause harm, delayed recovery and complications for patients. The CHEERS acronym is an aide-memoire that encapsulates those goals that fluid management should seek to meet, reflecting the principles of enhanced recovery. Patients should be encouraged to eat and drink right up to the limits defined for them preoperatively. Clear carbohydrate-based drinks up to two hours before surgery mean that patients are in a metabolically fed state that reduces postoperative insulin resistance, and restores an earlier return to normal gut function. Clinicians should be ever mindful of the importance of giving the right amount of fluid…. not too much….not too little and avoiding salt-rich unbalanced solutions that cause harm.

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C.H.E.E.R.S

  • Carbohydrate loaded (not hungry)
  • Hydrated (not thirsty)
  • Euvolaemic (the right amount of fluid)
  • Eunatraemic (the right amount of salt)
  • Ready to
  • Start to

DR.EA.M

  • DRink
  • EAt and
  • Mobilise ….

As soon as possible, achieving this on the same day of surgery in many instances, or the following day.