Coxon, A., Nielsen, K.M. orcid.org/0000-0001-9685-9570, Cross, J. et al. (1 more author) (2017) Implementing enhanced recovery pathways: a literature review with realist synthesis. Hospital practice, 45 (4). pp. 165-174. ISSN 2154-8331
Abstract
Objectives: Enhanced Recovery Pathways (ERPs) are an increasingly popular, evidenced-based approach to surgery, designed to improve patient outcomes and reduce costs. Despite evidence demonstrating the benefits of these pathways, implementation and adherence have been inconsistent. Methods: Using realist synthesis, this review explored the current literature surrounding the implementation of ERPs in the UK. Knowledge consolidation between authors and consulting with field experts helped to guide the search strategy. Relevant medical and social science databases were search from 2000 to 2016, as well as a general web search. A total of 17 papers were identified, including original research, reviews, case studies and guideline documents. Full texts were analysed, cross-examined, and data extracted and synthesised. Results: Several implementation strategies were identified, including the contexts in which these operated, the subsequent mechanisms of action that were triggered, and the outcome patterns they produced. Context-Mechanism-Outcome (CMO) configurations were generated, tested, and refined. These were grouped to develop two programme theories concerning ERP implementation, one related to the strategy of consulting with staff, the other with appointing a change agent to coordinate and drive the implementation process. These theories highlight instances in which implementation could be improved. Conclusion: Current literature in ERP research is primarily focussed on measuring patient outcomes and cost effectiveness, and as a result, important detail regarding the implementation process is often not reported or described robustly. This review not only provides recommendations for future improvements in ERP implementation, but also highlights specific areas of focus for furthering ERP implementation research.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2017 Informa UK Limited, trading as Taylor & Francis Group. This is an Accepted Manuscript of an article published by Taylor & Francis in Hospital Practice on 12 July 2017, available online: http://www.tandfonline.com/10.1080/21548331.2017.1351858. |
Keywords: | Enhanced Recovery; Implementation; Realist Synthesis; Change agency; CMO configuration; Context-Mechanism-Outcome |
Dates: |
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Institution: | The University of Sheffield |
Academic Units: | The University of Sheffield > Faculty of Social Sciences (Sheffield) > Management School (Sheffield) |
Depositing User: | Symplectic Sheffield |
Date Deposited: | 07 Jul 2017 15:03 |
Last Modified: | 20 Oct 2023 14:20 |
Status: | Published |
Publisher: | Mcgraw Hill |
Refereed: | Yes |
Identification Number: | 10.1080/21548331.2017.1351858 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:118637 |