Enhanced recovery pathways and patient‐reported outcome measures in gynaecological oncology

Summary Comprehensive peri‐operative care for women with gynaecological malignancy is essential to ensure optimal clinical outcomes and maximise patient experience through the continuum of care. Implementation of peri‐operative enhanced recovery pathways in gynaecological oncology have been repeatedly shown to improve postoperative recovery, decrease complications and reduce healthcare costs. With increasing emphasis being placed on patient‐centred care in the current healthcare environment, incorporation of patient‐reported outcome data collection and analysis within the enhanced recovery pathway as part of quality measurement is not only useful, but necessary. Inclusion of patient‐reported outcome enhanced recovery pathway evaluation enables clinicians to capture authentic patient‐reported parameters such as subtle symptoms, changes in function and multiple dimensions of well‐being, directly from the source. These data guide the treatment course by encouraging shared decision‐making between the patient and clinicians and provide the necessary foundation for ongoing peri‐operative quality improvement efforts. Elements of the gynaecological oncology enhanced recovery pathway are divided into five phases of care: pre‐admission; pre‐operative; intra‐operative; postoperative; and post‐discharge. The development process starts with detailing each step of the patient's journey in all five phases, then identifying stakeholder groups responsible for care at each of these phases and assembling a multidisciplinary team including: gynaecologists; anaesthetists; nurses; nutritionists; physical therapists; and others, to provide input into the institutional pathway. To practically integrate patient‐reported outcomes into an enhanced recovery pathway, a validated measurement tool should be incorporated into the peri‐operative workflow. The ideal tool should be concise to facilitate longitudinal assessments by the clinical staff.