Clinicians' views on implementing enhanced recovery after surgery: a descriptive qualitative study

Area of Science:

• Surgical protocols
• Healthcare management
• Patient recovery

Background:

• Enhanced Recovery After Surgery (ERAS) protocols aim to improve patient outcomes and reduce healthcare costs.
• Despite existing for decades, ERAS implementation faces challenges, with limited research on promoting its use.
• Understanding barriers and enablers is key to successful ERAS integration.

Purpose of the Study:

• To identify and describe the specific barriers and enablers encountered during ERAS implementation.
• To provide insights into the factors influencing the adoption of ERAS protocols in clinical practice.

Main Methods:

• A qualitative descriptive study design was employed.
• Semi-structured interviews were conducted with surgeons, anesthetists, and nurses, guided by the Theoretical Domains Framework.
• Data analysis involved inductive and deductive content analysis.

Main Results:

• Three main categories emerged, aligning with 12 domains of the Theoretical Domains Framework.
• Clinicians generally view ERAS as evidence-based, but awareness and motivation vary.
• Strategies to build momentum and the necessity of resources (staffing, time, tools) for ERAS were identified.

Conclusions:

• Motivational strategies are essential to encourage individual clinician adoption of ERAS.
• Adequate resources, including staffing and time, are necessary to support ERAS implementation.
• Strong hospital leadership support is vital for the successful integration of ERAS protocols.