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[Implementation of a fast track program : Challenges and solution approaches]
C van Beekum1, B Stoffels2, M von Websky2
1Klinik und Poliklinik für Allgemein‑, Viszeral‑, Thorax- und Gefäßchirurgie, Universitätsklinikum Bonn, Sigmund-Freud-Str. 25, 53127, Bonn, Deutschland. cornelius.vanbeekum@ukbonn.de.
Summary
Fast track surgery improves patient outcomes but faces low implementation rates due to multifactorial obstacles. Addressing these requires interdisciplinary teams, training, and patient involvement for successful adoption.
Area of Science:
- Surgical innovation
- Patient recovery protocols
Background:
- Fast track surgery, primarily in colorectal procedures, has a decade-long history of reducing complications and hospital stays.
- Despite proven benefits, implementation rates for fast track surgery measures remain low, often below 44%.
Purpose of the Study:
- To investigate obstacles hindering the implementation of fast track surgery.
- To propose solutions for overcoming these barriers and establishing multimodal recovery protocols.
Main Methods:
- Critical evaluation of international literature.
- Focus on prospective clinical trials and expert recommendations.
Main Results:
- Obstacles to fast track surgery implementation are multifactorial.
- Key barriers include time constraints, logistical challenges, lack of collegial support, healthcare system limitations, and patient-specific factors.
Conclusions:
- Successful fast track surgery requires an interdisciplinary team with low hierarchy, continuous training, and positive feedback.
- Early integration of personnel and patients enhances satisfaction and adherence to the fast track concept.
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