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Consensus on Training and Implementation of Enhanced Recovery After Surgery: A Delphi Study.

Nader K Francis1,2, Thomas Walker3, Fiona Carter4

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Consensus was reached on Enhanced Recovery After Surgery (ERAS) training, emphasizing evidence-based principles and team-oriented approaches. This expert guidance aims to improve ERAS program implementation and effectiveness through standardized training and centers of excellence.

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Area of Science:

  • Surgical Practice
  • Medical Education
  • Healthcare Management

Background:

  • Enhanced Recovery After Surgery (ERAS) is crucial for patient outcomes but faces implementation challenges.
  • Variable compliance with ERAS protocols necessitates effective staff education.
  • Optimal training curricula and assessment methods for ERAS remain undefined.

Purpose of the Study:

  • To establish expert consensus on successful ERAS training and implementation.
  • To define components of an ERAS training curriculum and course structure.
  • To develop frameworks for ERAS implementation, audit, training assessment, and centers of excellence.

Main Methods:

  • A modified Delphi technique involving 58 international experts across multiple specialities.
  • Three rounds of questionnaires administered between January 2016 and February 2017.
  • Interrogation of expert opinions on ERAS training, implementation, assessment, and centers of excellence.

Main Results:

  • ERAS training must include evidence-based principles and team-oriented learning.
  • Successful ERAS implementation requires strong leadership, a dedicated facilitator, and an effective multidisciplinary team (MDT).
  • Training effectiveness is measurable by improved compliance; centers of excellence demonstrate a commitment to teaching and teamwork.

Conclusions:

  • An international expert consensus provides a standardized ERAS training curriculum.
  • A framework for successful ERAS implementation and effectiveness assessment is proposed.
  • Criteria for defining ERAS training centers of excellence are established.