Enhanced Recovery After Surgery: Implementation Strategies, Barriers and Facilitators

Emily A Pearsall; Robin S McLeod

doi:10.1016/j.suc.2018.07.007

Enhanced Recovery After Surgery: Implementation Strategies, Barriers and Facilitators

Surg Clin North Am. 2018 Dec;98(6):1201-1210. doi: 10.1016/j.suc.2018.07.007. Epub 2018 Aug 24.

Authors

Emily A Pearsall¹, Robin S McLeod²

Affiliations

¹ Best Practice in Surgery, Department of Surgery, University of Toronto, 149 College Street, 5th Floor, Toronto Ontario M5T 1P5, Canada.
² Quality and Best Practices, Department of Surgery, University of Toronto, 149 College Street, 5th Floor, Toronto Ontario M5T 1P5, Canada; Clinical Programs and Quality Initiatives, Cancer Care Ontario, 620 University Avenue, 16th floor, Toronto, ON M5G 2L7, Canada. Electronic address: robin.mcleod@cancercare.on.ca.

PMID: 30390852
DOI: 10.1016/j.suc.2018.07.007

Abstract

Numerous reports have documented the effectiveness of Enhanced Recovery after Surgery (ERAS) pathways in improving recovery and decreasing morbidity and length of stay. However, there is also increasing evidence that ERAS^® guidelines are difficult to adopt and require the commitment of all members of the perioperative team. Multiple barriers related to limited hospital resources (financial, staffing, space restrictions, and education), active or passive resistance from members of the perioperative team, and lack of data and/or education have been identified. Thus, ERAS^® guidelines require a tailored implementation strategy to increase adherence.

Keywords: Barriers; Facilitators; Implementation; Knowledge translation; Quality improvement.

Publication types

Review

MeSH terms

Clinical Protocols*
Health Services Accessibility*
Humans
Perioperative Care*
Postoperative Complications / prevention & control*
Quality Improvement*
Recovery of Function*