A Qualitative Study Assessing the Barriers to Implementation of Enhanced Recovery After Surgery
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Previous studies have quantitatively assessed Enhanced Recovery After Surgery (ERAS) guideline implementation and compliance, and identified the existence of compliance issues with the programs. This is the first study to qualitatively assess the reasons behind compliance issues in ERAS programs. The aim of this study was to elicit barriers to implementation and functioning of the ERAS program at Royal Prince Alfred Hospital.
A series of interviews were carried out with key stakeholders in order to explore barriers preventing effective functioning of the program 1 year after implementation. Interview transcripts were analysed. Data analysis involved a grounded theory methodology.
Analysis of the data identified four key themed areas of practice that presented barriers: patient-related factors, staff-related factors, practice-related issues, and resources. These overarching themes were generated from subcategories that were linked to generate theory.
For the ERAS program to be implemented successfully with high levels of element compliance, the four key areas need to be addressed. As barriers to ongoing effective care become apparent, these should be managed in order to optimize the synergistic effects of this multimodal program of patient care.
KeywordsRoyal Prince Alfred Hospital Discharge Resource Health System Resource Stoma Therapy Elective Laparoscopic Colonic Resection
Conflict of interest
The authors have not identified any potential or real conflicts of interest.
- 9.Bickman L, Rog DJ (2005) The SAGE handbook of applied social research methods, vol 2. Sage Publications, Thousand Oaks, p 236Google Scholar
- 10.Woods P (2006) A standard approach to organisation in successful writing for qualitative researchers, vol 2. Routledge, New York, pp 32–35Google Scholar
- 17.Raymond TM, Kumar S, Dastur JK, Adamek JP, Khot UP, Stewart MS, Parker MC (2010) Case controlled study of the hospital stay and return to full activity following laparoscopic and open colorectal surgery before and after the introduction of an enhanced recovery programme. Colorectal Dis 12:1001–1006PubMedCrossRefGoogle Scholar
- 25.Hathaway D (1996) Effect of pre-operative instruction on post-operative outcomes: a meta-analysis. Nurs Res 35(5):269–275Google Scholar