Table 7 Collective action—supporting quotes

Chief support

I think you have to give some credit to the chief in Anesthesia. He accepted the ideas almost right away and [study PI] and I went to speak to the chief of all departments directly and he supported it. (Anaesthesiologist)

It took a lot to get [name] onboard. He’s the Chief of Anesthesia. He kind of had the attitude of, which really pissed me off, sorry, “oh, we don’t need cheerleaders. We just need to do it. Like people will just adjust." Well, no, you need the education. People will have questions and answers and you know, giving opportunity to ask questions so they understand. I mean, I think that was a big big hurdle there. He was very difficult to get onboard. (Anaesthesiologist)

Systems integration

We’ve actually automated it so it appears on our OR schedule. Senior management asked our IT guys to associate ERAS procedures with the tag “ERAS.” So on our OR record, they show up as “ERAS rt hemicolectomy” as a flag to both surgical and anesthesia team that this patient is an ERAS patient. (Anaesthesiologist)

The anesthesiologists aren’t unique to colorectal so it was a much bigger group of people to try and engage. You know, several months after we started, I'd be in the room with an anesthesiologist and they’d say, “so what’s this ERAS anyway?” So there was a piece of education there that was a bit harder to do. (Surgeon)