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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
1Department of Colorectal Surgery, Yeovil District Hospital Foundation Trust, Higher Kingston, Yeovil, Somerset, BA21 4AT, UK. nader.francis@ydh.nhs.uk.
World Journal of Surgery
|January 6, 2018
Summary
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.
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.
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