Development of an Enhanced Recovery After Surgery Surgical Safety Checklist Through a Modified Delphi Process.

Area of Science:

• Perioperative Medicine
• Surgical Safety
• Evidence-Based Practice

Background:

• Enhanced Recovery After Surgery (ERAS) guidelines and the World Health Organization Surgical Safety Checklist (SSC) are critical for optimizing perioperative patient outcomes.
• Integrating these established tools can streamline critical perioperative decision-making processes.

Framework:

• A modified Delphi consensus model involving international ERAS experts was employed to evaluate ERAS recommendations for inclusion in an SSC.
• Twenty-seven colorectal and gynecologic oncology ERAS recommendations were assessed for appropriateness, leading to the development of ERAS-specific SSC prompts.

Implementation:

• A 3-round Delphi process with 105 experts from 18 countries informed the development of an ERAS-specific SSC.
• Universal consensus was reached on 37 prompts for a 3-part ERAS-SSC, covering key phases: pre-anesthesia, skin incision, and departure from the operating theater.

Implications:

• The developed ERAS-SSC expands upon the WHO SSC, incorporating crucial elements like analgesia, nausea prevention, fluid management, and DVT prophylaxis.
• The ERAS-SSC is ready for direct adoption or can be used to modify existing institutional SSCs, facilitating implementation of ERAS protocols for major surgeries.