Patient Experience Pre-Implementation of an Enhanced Recovery After Surgery Protocol: A Qualitative Investigation

Abstract

Bianca Poletti,1 Georgia Stringer,2 Kate Furness3,4 1Faculty of Health Science (Biomedical Science), Swinburne University of Technology, Hawthorn, Victoria, 3122, Australia; 2Department of Nutrition and Dietetics, Eastern Health, Melbourne, Australia; 3Department of Nursing and Allied Health, Swinburne University of Technology, Hawthorn, Victoria, 3122, Australia; 4Department Sport, Exercise and Nutrition Sciences, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, 3086, AustraliaCorrespondence: Kate Furness, La Trobe University, Department of Sport, Exercise and Nutrition Sciences, School of Allied Health, Human Services and Sport, Bundoora, Victoria, 3086, Australia, Email [email protected]: This study explores the experience of adults undergoing major abdominal surgery pre-implementation of an Enhanced Recovery after Surgery program at a tertiary hospital in Melbourne, Australia, to enhance health promotion in Australian hospitals.Methodology: Patients who were undergoing major abdominal surgery and who consented to participate were recruited in this study. Patients were chosen based on an inclusion-exclusion criterion. In-depth, semi-structured qualitative interviews were conducted by telephone and transcribed verbatim by the primary researcher. Thematic analysis was used and synthesised into five inductive themes. Eighteen participants aged between 51 and 82 years were interviewed. Codes were categorised into inductive themes: 1) preparedness for surgery; 2) communication; 3) aftercare; 4) expectations of surgery; and 5) overall experience utilising an iterative process. The following themes and subthemes emerged from the qualitative synthesis.Results: Patients undergo a variety of experiences throughout the perioperative care period. Patient care and experience may be improved through increased access to patient engagement, information and communication, use of multimedia and teach-back method, optimization of the hospital environment and through providing adequate planning and support on discharge.Conclusion: Evidence of barriers to enhancing patient surgical experience can be used to guide the implementation of Enhanced Recovery after Surgery protocols in Australian hospitals and therefore may limit its generalizability. This will improve health promotion as these findings provide valuable insights into integrative methods that can be considered to be important for achieving person-centred care. This knowledge can be useful in clinical practice, implementation and education programs for ERAS.Keywords: patient care, perioperative care, patient engagement, communication, surgery

Keywords

• patient care
• perioperative care
• patient engagement
• communication
• surgery.