Enhanced Recovery after Surgery (ERAS) in Gynecology: State of the Art and the Problem of Barriers
Objectives: The advantages of the enhanced recovery after surgery (ERAS) protocols application in all surgical branches have been largely demonstrated, even though there is a lack of a strong evidence from randomized trial and the evidence regarding the multimodality treatments is of low grade. More...
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| Format: | Article |
| Language: | English |
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IMR Press
2023-01-01
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| Series: | Clinical and Experimental Obstetrics & Gynecology |
| Subjects: | |
| Online Access: | https://www.imrpress.com/journal/CEOG/50/1/10.31083/j.ceog5001014 |
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| _version_ | 1849701891158573056 |
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| author | Sara Forte Filippo Alberto Ferrari Hooman Soleymany Majd Francesca Cisotto Federico Ferrari |
| author_facet | Sara Forte Filippo Alberto Ferrari Hooman Soleymany Majd Francesca Cisotto Federico Ferrari |
| author_sort | Sara Forte |
| collection | DOAJ |
| description | Objectives: The advantages of the enhanced recovery after surgery (ERAS) protocols application in all surgical branches have been largely demonstrated, even though there is a lack of a strong evidence from randomized trial and the evidence regarding the multimodality treatments is of low grade. Moreover, the problem of the barriers to the implementation of these protocols in clinical practice remains an unsolved problem. Mechanism: We performed a narrative review reporting the main barriers and enablers on the subject. Finding in Brief: The main barriers are resistance to change, lack of support from institutions and of financial resources or manpower, poor communication and collaboration within the multidisciplinary team, organizational problems, lack of standardized protocols, patient-related barriers (individual factors, reluctance, or inadequate education) and lastly clinical practice in small community hospitals. To overcome these problems, several enablers have been identified including: the involvement of the patient, the reorganization of care systems through standardized ERAS protocols, identification of a leader/coordinator, promotion of teamwork and staff education, financial resources, and the recognition of the role of the professionals involved. Conclusions: At this moment, resistance to change remains the most frequent and difficult barrier to overcome and, in our opinion, a reorganization of the health system aiming to the implementation of the ERAS protocols in the clinical practice is required. |
| format | Article |
| id | doaj-art-1e85aa11539e479cb2a22c37535a8cf0 |
| institution | DOAJ |
| issn | 0390-6663 |
| language | English |
| publishDate | 2023-01-01 |
| publisher | IMR Press |
| record_format | Article |
| series | Clinical and Experimental Obstetrics & Gynecology |
| spelling | doaj-art-1e85aa11539e479cb2a22c37535a8cf02025-08-20T03:17:48ZengIMR PressClinical and Experimental Obstetrics & Gynecology0390-66632023-01-015011410.31083/j.ceog5001014S0390-6663(22)01932-7Enhanced Recovery after Surgery (ERAS) in Gynecology: State of the Art and the Problem of BarriersSara Forte0Filippo Alberto Ferrari1Hooman Soleymany Majd2Francesca Cisotto3Federico Ferrari4Department of Clinical and Experimental Sciences, University of Brescia, 25121 Brescia, ItalyDepartment of Obstetrics and Gynecology, AOUI-University of Verona, 37100 Verona, ItalyDepartment of Gynaecologic Oncology, Oxford University Hospitals, OX1 Oxford, UKDepartment of Clinical and Experimental Sciences, University of Brescia, 25121 Brescia, ItalyDepartment of Clinical and Experimental Sciences, University of Brescia, 25121 Brescia, ItalyObjectives: The advantages of the enhanced recovery after surgery (ERAS) protocols application in all surgical branches have been largely demonstrated, even though there is a lack of a strong evidence from randomized trial and the evidence regarding the multimodality treatments is of low grade. Moreover, the problem of the barriers to the implementation of these protocols in clinical practice remains an unsolved problem. Mechanism: We performed a narrative review reporting the main barriers and enablers on the subject. Finding in Brief: The main barriers are resistance to change, lack of support from institutions and of financial resources or manpower, poor communication and collaboration within the multidisciplinary team, organizational problems, lack of standardized protocols, patient-related barriers (individual factors, reluctance, or inadequate education) and lastly clinical practice in small community hospitals. To overcome these problems, several enablers have been identified including: the involvement of the patient, the reorganization of care systems through standardized ERAS protocols, identification of a leader/coordinator, promotion of teamwork and staff education, financial resources, and the recognition of the role of the professionals involved. Conclusions: At this moment, resistance to change remains the most frequent and difficult barrier to overcome and, in our opinion, a reorganization of the health system aiming to the implementation of the ERAS protocols in the clinical practice is required.https://www.imrpress.com/journal/CEOG/50/1/10.31083/j.ceog5001014erasgynecological surgeryprotocol implementation |
| spellingShingle | Sara Forte Filippo Alberto Ferrari Hooman Soleymany Majd Francesca Cisotto Federico Ferrari Enhanced Recovery after Surgery (ERAS) in Gynecology: State of the Art and the Problem of Barriers Clinical and Experimental Obstetrics & Gynecology eras gynecological surgery protocol implementation |
| title | Enhanced Recovery after Surgery (ERAS) in Gynecology: State of the Art and the Problem of Barriers |
| title_full | Enhanced Recovery after Surgery (ERAS) in Gynecology: State of the Art and the Problem of Barriers |
| title_fullStr | Enhanced Recovery after Surgery (ERAS) in Gynecology: State of the Art and the Problem of Barriers |
| title_full_unstemmed | Enhanced Recovery after Surgery (ERAS) in Gynecology: State of the Art and the Problem of Barriers |
| title_short | Enhanced Recovery after Surgery (ERAS) in Gynecology: State of the Art and the Problem of Barriers |
| title_sort | enhanced recovery after surgery eras in gynecology state of the art and the problem of barriers |
| topic | eras gynecological surgery protocol implementation |
| url | https://www.imrpress.com/journal/CEOG/50/1/10.31083/j.ceog5001014 |
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