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Children’s Integrated Recovery Pathways (CHIRPs)

What is the Children's Integrated Recovery Pathways?

CHIRPs relates to enhanced recovery in a paediatric environment. This is a new approach to the care of patients following a surgical or medical procedure, both elective and non-elective.  It is a modern, evidence based approach where different members of the hospital and primary care team work together in order to ensure that the patients are:

  • in the best possible condition before their operation,
  • better prepared for their hospital stay and
  • able to feel better sooner after their operation.

Although enhanced recovery is now becoming widespread within the NHS, it is predominantly within adult acute services, including the Division of Surgery in Manchester Royal Infirmary. Royal Manchester Children's Hospital (RMCH) is the first children's hospital in the UK to introduce enhanced recovery in the form of Children's Integrated Recovery Pathways.

In hospital sites where this approach is the norm, they have reported significant improvement in:

  • patient experience,
  • clinical outcomes and
  • professional relationships/teamwork.

Goals and Objectives

  • to improve quality of care and clinical outcomes and consequently improve the child's experience whilst in hospital,
  • to allow the child to recover from surgery more quickly and leave hospital sooner,
  • better coordination with pre-operative arrangements,
  • a closer working relationship with the Children's Community Nursing teams.

How does CHIRPs work?

We want patients to play an active role in their recovery and we aim to do this by giving:

  • open and honest communication regarding the child's condition and treatment,
  • accurate information regarding the child's treatment and hospital stay and any relevant pre-operative education.

We want patients to have the best possible management during and after their operation.  We aim to do this by:

  • reducing pain with good anaesthetic techniques, medication and using minimally invasive surgical techniques where appropriate,
  • reducing immobilisation by encouraging activity and removing drips, drains and catheters as early as possible, and
  • reducing post -operative nausea and vomiting with good fluid balance control and medications.

We recognise that leaving hospital after an operation can be daunting after having 24 hour support from qualified staff so up to date discharge information and appropriate contact details if there are concerns will formulate part of the discharge process. This may include hospital staff, a Nurse Specialist or community contact depending on the procedure performed.

Further details can be obtained by contacting our Modern Matron, Julie Jolly on 0161 701 2192 or julie.jolly@cmft.nhs.uk