Paving the Road to Enhanced Recovery After Cesarean at a New York City Municipal Hospital: A Quality Improvement Initiative to Optimize Multimodal Analgesia in the First 24 Hours After Cesarean Delivery

Enhanced Recovery After Cesarean (ERAC) guidelines encourage multimodal analgesia, which has been demonstrated to reduce pain, improve mobility, and decrease opioid use. Standardizing care through protocols has also been shown to contribute to reducing disparities, of particular importance at our safety net hospital where most patients are low-income Black, Indigenous, and People of Color. We seek to optimize the use of multimodal analgesia in preparation for institution-wide ERAC implementation by leveraging data and quality improvement (QI) tools to identify current gaps in performance and design stakeholder-driven interventions.

AIM STATEMENT: To increase the percentage of patients receiving all possible doses of non-opioid analgesics before receiving opioids in the first 24 hours after Cesarean by 50% by September 2024