Review of Total Knee replacement (TKR) Enhanced Recovery After Surgery (ERAS) Programme
Care Process & Redesign
Singapore Healthcare Management Congress
SingHealth
11 February 2026
To review and analyse the current workflow of the TKR ERAS Programme, to improve the information flow among the staff and. The team will continue to improve the overall length of stay by increasing the ERAS uptake for this programme through engagement with.
Year Submitted: 2025
Published Date: 11 February 2026
Tags: Care Process ＆ Redesign, Workflow Redesign, Quality Improvement, Cost Saving, Productivity, Value Based Care, Length Of Stay
About this Content
Aims
To review and analyse the current workflow of the TKR ERAS Programme, to improve the information flow among the staff and patients for easier coordination and better communication while managing the expansion of the ERAS programme.
Background
The Enhanced Recovery After Surgery (ERAS) Programme for Total Knee Replacement (TKR) started in 2019 as an evidence-based multi-disciplinary approach to peri-operative management of patients after major surgery. This approach has been proven to decrease complications, readmissions, length of stay, together with improvements in patient-reported outcomes and functional recovery.
Methods
The team mapped out the patient journey workflow to understand the various touchpoints with patients. The communication channel used by the healthcare professionals were also analysed to identify the challenges faced in the ERAS programme.
Results
Reduction in the average LOS from a median of 3.5 days to 2.7 days. Percentage of patient onboard the programme reaches 47% for Q2 CY2024. Annual patient cost savings of $70,022 due to reduced LOS. Median percentage of patients warded at SSW increase from 70.1% to 83.7%. Re-billing rates remained stable at 1 per week.
Conclusion
The team will continue to improve the overall length of stay by increasing the ERAS uptake for this programme through engagement with the various healthcare professionals involved in the process.
Lessons Learnt
Implementation of the ERAS programme has yielded remarkable results in optimising healthcare delivery and resource management, as evidenced by the decrease in ALOS. The programme's ability to maintain these favourable results consistently underscores its sustainability and effectiveness in elevating the standard of patient care.
Additional Information
Enhanced collaboration efforts with NTUC Health, to ensure that SGH, NTUC and patients are integrated into new workflows.
This project was conferred the Merit Award for Operations Category at SHMC 2025.
Keywords
Length of Stay, Total Knee Replacement, Enhanced Recovery After Surgery
Innovators' Details
Innovators' Details
Healthcare Cluster(s) | SingHealth |
Organization(s) Involved | Singapore General Hospital |
Platform(s) | Singapore Healthcare Management Congress |
Healthcare Professional Group(s) | Nursing, Medical, Healthcare Administration, Allied Health |
Applicable Specialty or Discipline | Orthopaedics, Surgery, Physiotherapy, Finance, Anaesthesiology |
Project Lead(s) | Pang Hee Nee |
Project Member(s) | Rajashulakshana D/O Rajaram |
Connect with this contributor!
Singapore Healthcare Management Conference (SHMC) Secretariat - singaporehealthcaremanagement@singhealth.com.sg