[ERAS Implementation] 導入ERAS教育及推廣之專家共識

ERAS Guidelines 雖有實證醫學背書,但實際的導入與臨床應用往往挑戰既有的思維與標準作業流程。成功的 ERAS 導入除了需要醫療機構系統性的支持之外,也需要第一線醫療人員持續的教與與訓練。ERAS Society透過delphi method取得58名來自11ERAS各領域的專家學者意見,經過反覆的討論與修正,建立共識於World Journal of Surgery發表第一篇針對ERAS Training and Implementation Consensus


針對ERAS教育訓練課程設計,專家們認為最重要的題:


針對如何教育ERAS課程,專家們認為最有效的方式:

  • Team-based training with a multidisciplinary faculty (96.67%)
  • Face-to-face training (93.33%)
  • Online modules/e-learning with integrated assessment (76.67%)
  • As part of the undergraduate nursing and medical curricula (76.67%)
  • Continual audit and feedback should be performed to demonstrate the benefits of teaching methods (73.33%).


針對ERAS成功導入,專家們認為要最重要的因素為:


針對ERAS的成功導入,專家們認為跨團隊合作最重要的因素為:

  • Development of an effective system of feedback (97%)
  • Strong leadership and vision (90%)
  • Regular scheduled meetings (80%)
  • Clearly aligned goals for patient care (80%)
  • Collaborative development of ERAS pathways (77%)


針對ERAS的成功導入,專家們認為ERAS leader最重要的因素為:

  • They must be passionate and positive about ERAS (97%)
  • Locally respected and able to influence clinical and management colleagues (97%).


針對ERAS的成功導入,專家們認為機構端要最重要的因素為:

  • Senior management engagement (87%)
  • Linking clinical outcomes of ERAS to organizationalobjectives (87%)
  • Including a senior manager within the ERAS team (80%)
  • Sharing the positive outcomes of ERAS with senior management (77%)


針對ERAS的成功導入,專家們認為ERAS nurse/facilitator最重要的因素為:

  • Enthusiastic team members with correct skills, abilities and time for role (86.67%)
  • Have clear roles and responsibilities (83.33%)


針對ERAS執行成果的評鑑,專家們認為最需要收集的資料為:


針對ERAS的資料收集,專家們認為最大阻礙與困難為:

  • A lack of human resources (4.13)
  • A lack of time (4.10)
  • Non-automated or inefficient processes (4.00)


針對ERAS的資料收集,專家們認為最佳的執行角色為:


針對ERAS教育訓練學程效率,專家們認為需要被評核的項目為:


針對ERAS教育訓練的評核,專家們認為最佳的資料收集方式為:

  • Prompt feedback from participants after each course (96.67%)
  • Follow-up of ‘‘trained’’ centres using faculty feedback (76.67%)
  • Feedback provided by faculty using standardized online feedback forms (70.00%)


針對ERAS訓練中心的成功,專家們認為最重要的條件為:


針對成功ERAS訓練中心,專家們認為機構應該達到的標準為

  • Publication of data (87.10%)
  • Scheduled observation visits (77.42%)
  • Both attendance and presentation at national or international meetings (74.19%).


論文連結:

Consensus on Training and Implementation of EnhancedRecovery After Surgery: A Delphi Study

Nader K. Francis et. al.

Published 04 January 2018