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A multicentre qualitative study assessing implementation of an Enhanced Recovery After Surgery program.
D Martin1, D Roulin1, F Grass1
1Department of Visceral Surgery, Lausanne University Hospital CHUV, Lausanne, Switzerland.
Clinical Nutrition (Edinburgh, Scotland)
|November 14, 2017
Summary
Implementing Enhanced Recovery After Surgery (ERAS) programs faces challenges. Key motivations include reducing complications and improving patient satisfaction, but time, colleague resistance, and logistics are significant barriers.
Area of Science:
- Perioperative Medicine
- Surgical Care Improvement
- Patient Recovery Protocols
Background:
- Enhanced Recovery After Surgery (ERAS) guidelines exist but face implementation barriers.
- Successful ERAS implementation requires addressing these challenges to optimize patient management.
- A survey assessed motivations, difficulties, and targets for ERAS perioperative care.
Purpose of the Study:
- To analyze motivations for implementing ERAS programs.
- To identify encountered difficulties and challenges in ERAS implementation.
- To assess the relevance of perioperative care items and postoperative recovery targets.
Main Methods:
- A multicentre qualitative study conducted from August to December 2016.
- Online survey distributed to surgeons, anaesthesiologists, and nurses in ERAS centers in Switzerland and Sweden.
- Survey included 31 closed questions with reminders sent over 12 weeks.
Main Results:
- A 52.7% response rate (77/146 experts) was achieved.
- Primary motivations for ERAS implementation: reduced complications (91%), higher patient satisfaction (73%), shorter hospital stay (62%).
- Major implementation barriers included time constraints (69%), colleague opposition (68%), and logistical issues (66%). Patient-related barriers included personality (52%), comorbidities (49%), and language (31%).
Conclusions:
- ERAS implementation necessitates significant clinical practice changes across all specialties.
- Motivations for ERAS are primarily reduced complications, shorter hospital stay, and improved patient satisfaction.
- Key barriers to ERAS adoption are time, resistance to change, and logistical challenges.
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