For the study, researchers searched six databases — PubMed, Medline, Cumulative Index to Nursing and Allied Health Literature Complete, Web of Science, PsychINFO and Cochrane Central Register of Controlled Trials — for articles published from 1990 to Nov. 30, 2016. They conducted a systematic review of articles that addressed barriers and facilitators of enhanced recovery pathway implementation.
In total, researchers studied 53 articles. They found the key facilitating factors for enhanced recovery pathway implementation were:
• Adapting the program to fit local contexts
• Achieving and demonstrating early “wins”
• Gaining buy-in from both frontline clinicians and hospital leadership
• Having a strong enhanced recovery pathway team that met regularly
• Leveraging supporters and full-time enhanced recovery pathway staff
The barriers identified were
• Meeting with resistance to change from frontline clinicians
• Not having enough resources for implementation
• External factors, such as patient complexity or rural location
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