ERAS® certification reaffirms NHG Health’s commitment towards delivering a consistent 'gold' standard of care for best surgical recovery outcomes for patients

At a Glance

• First in Singapore: NHG Health is the first public healthcare group in Singapore where all its hospitals – Tan Tock Seng Hospital (TTSH), Khoo Teck Puat Hospital (KTPH), and Woodlands Hospital (WH) – are ERAS®-certified by the international ERAS® Society.
• Built on a decade of evidence: TTSH has been ERAS®-certified since 2016 and is one of only two ERAS® Centres of Excellence in Asia. KTPH and WH are the most recent additions to put in place the ERAS® Interactive Audit System (EIAS).
• Cluster-wide impact: The NHG Health ERAS® model of care now standardises perioperative care across all three hospitals.
• Measurable patient outcomes: Total knee replacement surgery stays reduced to about 2 days; and bariatric surgery patients often discharged in less than 2 days.
• What’s Next: Expansion of ERAS® principles in a systematic way to other surgical subspecialties and also general surgical procedures, including inguinal hernia repair and cholecystectomy.

Singapore, 13 May 2026 – Patients undergoing major surgery at Singapore’s NHG Health hospitals are now receiving a guaranteed “gold” standard of care to enhance their recovery after surgery. All three of its hospitals are now certified by the ERAS® Society for having met the standards of Enhanced Recovery After Surgery.

The certification, awarded by the international non-profit that produces globally recognised evidence-based perioperative guidelines and sets ERAS® standards worldwide, recognises a consistently high level of evidence‑based perioperative care and good outcomes across Tan Tock Seng Hospital (TTSH), Khoo Teck Puat Hospital (KTPH), and Woodlands Hospital (WH).

It is an important milestone that affirms NHG Health’s commitment to a systematic and evidence-based approach towards care of its surgical patients. This also forms the basis for delivering value-based care in surgery at NHG Health. Certification ensures that these high standards of care and good outcomes are sustained in the long term and remain the standard of care at NHG Health.

What is Enhanced Recovery After Surgery (ERAS®)?

ERAS® is an evidence-based, multidisciplinary and multimodal approach to surgical care that covers the entire patient journey, not just the operation itself. It includes:

• Before surgery: Individualised patient optimisation, preparation and counselling on what to expect, emphasising their roles in preparing for and recovery after surgery.
• During surgery: Advanced anaesthetic and surgical techniques, minimally invasive where possible, to reduce surgical stress of surgery and preserve function.
• After surgery: Early mobilisation, early oral nutrition, optimal pain control, and avoidance of unwarranted tubes and drains.

When ERAS® guidelines are well adhered to consistently, evidence shows better recovery, fewer post operative complications and shorter hospital stays with no increase in readmissions or mortality.

How NHG Health’s ERAS® Journey Evolved?

TTSH was the first hospital in Singapore to receive the ERAS® Centre of Excellence status in 2016 for colorectal surgery. It remains one of only two ERAS® Centres of Excellence in Asia, acting as a regional hub for ERAS® implementation.

Over the past 10 years, NHG Health’s hospitals have progressively adopted ERAS® protocols across selected surgical sub-specialties, including colorectal surgery, total knee replacement, breast surgery, and bariatric surgery, among others. KTPH and WH have since achieved their own ERAS® certifications, joining TTSH in meeting the same internationally benchmarked standards.

The cluster-wide approach towards ERAS® implementation formalises the work that brings together multidisciplinary teams from TTSH, KTPH and WH to adopt evidence-based standardised practices, refine workflows, and measure clearly defined patient outcomes. This ensures reduction in unwarranted variations in care and allows benchmarking across the hospital to spur continuous vigilance and improvement.

“ERAS® is about organising care around the patient so that patients recover better and faster, by tailoring the programme to individual needs and ensuring that every member of the care team, including the patient and family, is fully aware of the goals of care and their responsibilities,” said Dr How Kwang Yeong, Clinical Director of NHG Health’s ERAS® Perioperative Care Office, who is also a senior consultant in the Department of General Surgery at TTSH.

“It is also about culture change, in the way we think, the way we work together, and the way we care for our patients. Clinical protocols are only as effective as the people and systems behind them,” he added.

What Cluster-wide ERAS® Looks Like in Practice?

A Dedicated ERAS® Ward at TTSH

Designed in 2024, TTSH’s ERAS® ward is a specialised surgical unit where doctors, nurses, allied health professionals and trained patient volunteers work together to support recovery in the critical hours and days after surgery. The environment is built around early mobilisation, early oral nutrition, and psychological and functional recovery. This model is now being scaled to the Integrated Care Hub at TTSH, KTPH and WH.

Prehabilitation for Higher-Risk Colorectal Surgery Patients at WH

At WH, ERAS® is applied to colorectal surgery especially for higher-risk patients – the elderly and those with multiple comorbidities. Before surgery, patients are counselled on recovery expectations and nutrition. They are also screened for optimisation needs, with referrals to dietitians and physiotherapists where appropriate. During surgery, minimally invasive techniques are used where possible to reduce surgical stress and anxiety. After surgery, early feeding, early mobilisation and prompt removal of tubes and drains help restore bowel function, reduce complications and shorten hospital stays, making operations safer for patients who would have faced higher risks.

One-stop, Coordinated Model of Care for Bariatric Surgery Patients at KTPH

At KTPH, the bariatric programme is delivered through the Integrated Care for Obesity and Diabetes model, which brings together multidisciplinary expertise to support patients with complex metabolic conditions. This coordinated approach addresses both obesity and diabetes in tandem, combining surgical care with medical optimisation, nutrition, and lifestyle support. By incorporating ERAS® principles, patients benefit from safer, faster recovery, with many able to return home within two days. The programme reflects NHG Health’s commitment to holistic, patient‑centred care for higher‑complexity surgical needs.

Bundled Care for Total Knee Replacement 

Across all three hospitals, total knee replacement patients move through ERAS®-based bundled care packages that transition them smoothly and quickly into community hospitals for focused rehabilitation. Patients recover in the right setting, and acute hospital beds stay available for those who need them most.

Positive Outcomes: What Our Data Shows

NHG Health’s ERAS® journey is underpinned by measurable improvements across multiple surgical pathways over the years:

These results are consistent with international evidence showing that ERAS® reduces hospital stays, and complications without increasing readmission or mortality.

What’s Next for ERAS® at NHG Health?

NHG Health is expanding ERAS® protocols and principles to additional surgical pathways, including other subspecialty and general surgical procedures like inguinal hernia repair and cholecystectomy.

Professor Joe Sim, Group Chief Executive Officer, NHG Health, said: “Having all three of our hospitals ERAS®-certified is a proud moment for us. By adopting ERAS® as the ‘gold’ standard framework for perioperative care, we are progressively elevating our patients’ surgical experience and outcomes, strengthening healthcare sustainability, and setting a new regional benchmark for surgical recovery.”