Skip to main content

Table 6 Capacity Building Theme; Quotes by Topic

From: Moving enhanced recovery after surgery from implementation to sustainability across a health system: a qualitative assessment of leadership perspectives

Capacity Building ThemeWhat builds ERAS capacity?
Change ManagementIn terms of challenges, the biggest thing was just the constant need for reinforcement about what we were doing, both on the surgeon side and the nursing side. That takes, once you implement a change…it seems to take a couple of years for them to adopt it and use it on a daily routine basis. Just ‘cause you’re so used to doing things the old ways. So I think the challenge is that people tend to fall backwards and the solution to that is just constantly reinforcing the value…
EducationThe thinking about mobilization and nutritional supplements and the modern fasting guidelines, we are not just initiating that education and teaching with the colorectal patients. We talk about that with all of our patients that are coming through the pre-admission clinic for all of our services. So, I think that there are a lot of aspects of ERAS that have sort of migrated over. The mobilization, the intraoperative fluid, I think we’re seeing more and more of that just become the change in how we deliver care. So I don’t think it’s a big leap to go add another service on full bore. That will be really easy because, like the nursing personnel, ERAS way of managing patients is now become the way they do care…. I think most units and areas embrace this because it is better for the patient.
TeamsI think we worked as a team. We had regular meetings for feedback. And if the ERAS nurse had a question and we usually addressed it quickly. At least we tried to. We would brainstorm for things that hadn’t happened yet… Sometimes different physicians they are used to doing certain things in a certain way so they might not implement as early as others. People who kind of … people who jumped on the ERAS band wagon. Some people are more resistant to change than others. But overall it was slowly but surely… Everyone helped each other. Everyone has their own silo but overall people have been helpful. But there is an ERAS nurse that helps to put it all together.