Table 8 Reflexive monitoring—supporting quotes

Use of data

Since we last got the ERAS report, we did a follow-up series of lunch and learns as well as breakfasts where we actually presented the data to the different areas, because it’s been about a year and a half that we’ve been involved in ERAS so we presented some of the data, as well as just thanked the staff for their contributions. (Nurse)

Need for audit and feedback

People need to see the impact of what they do. And that will be a challenge in that continuing to have information readily available to show the impact of what they’re doing and help them understand what they do makes a difference. I think that’s something that will make it sustainable. But that’s challenging because right now, we’re actively collecting data on these patients and that will eventually go away. (Surgeon)

Evidence of a culture change

I do think there’s been a culture shift. I think that’s something that really can take a long time. I don’t think we’re 100% there yet but I think we made some great strides in that way. Because that for me is one of the most important things is if you’re going to have sustainability you have to have people believe in the program, believe in the guidelines. (Nurse)

Normalization of ERAS

I want to actually get rid of the word ERAS completely just because I think it makes people think that there is something else other than enhancing someone’s recovery. There is nothing else. Every patient you’re trying to enhance their recovery. So there is no patient who shouldn’t be ERAS. (Surgeon)

I think people don’t even think of it as a trial or a project anymore and I think the data’s already reflected that it’s been beneficial for our length of stay. So it’s not as though from our point of view, things are going to change. Everyone’s going to treat all colorectal surgery cases with an ERAS protocol at our hospital. I think people realize it’s the way it’s going to be. (Anaesthesiologist)