Factors distinguishing higher-performing hospitals in implementing enhanced recovery pathways

Implementing enhanced recovery pathways in hospitals varies widely. This qualitative study analyzed interviews with perioperative leaders, clinicians, and staff from eight US hospitals to identify factors that distinguished hospitals with greater success in implementing these pathways. The study found that information-sharing practices, planning, engaging, positive knowledge and beliefs among clinicians, and strong leadership support were consistently positive factors associated with successful implementation. Conversely, factors such as pathway complexity, hospitals’ infrastructure, and challenges in altering electronic health record systems were consistently negative barriers to implementation success.