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11國ERAS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發表了第一篇針對ERAS Training and Implementation Consensus。

針對ERAS教育訓練的課程設計，專家們認為最重要的課題：

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的成功導入，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教育訓練學程的效率，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：

針對成功的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