ArticleAnnals of surgery2026
Hospital Configurations Leading to Successful Implementation of Enhanced Recovery Programs.
Article in Annals of surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
1 citing paper in PubMed.
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Authors and funding
8 authors.
Funding
Abstract
objectiveThis study explains successful implementation of hospital enhanced recovery programs (ERPs) through unique configurations of contextual and implementation conditions.
backgroundDespite proven benefits in improving surgical outcomes, ERPs are often ineffectively implemented in hospitals, possibly due to the complex ways in which the interventions, local environment contexts, and implementation processes intertwine.
methodsUsing coincidence analysis, a mathematical method for analyzing configurations, we identified sufficient and necessary conditions for ERP implementation success in a national surgical collaborative. Success (high improvement) was defined as being among the 25% of hospitals with the greatest improvement in ERP adherence rate over time. Explanatory conditions included implementation resources in 5 domains (knowledge of evidence supporting interventions, leadership support, team skills and cohesion, stakeholder buy-in, and appropriate workload and time), organizational readiness to change, and hospital characteristics (teaching status, bed size, surgical volume, and socioeconomic status of patient populations). Prevalence-adjusted (PA) consistency and contrapositive coverage, measures of data fit, were used in model selection, adjusting for outcome prevalence.
resultsOf the 86 hospitals, 26 (30.2%) successfully implemented ERP. Three scenarios collectively explained success for >70% of the hospitals (PA consistency=0.719, prevalence-adjusted contrapositive coverage=0.752): Low socioeconomic status hospitals ready to change despite lacking team skills and cohesion during implementation; hospitals with low surgical volume which were ready to change and had strong staff buy-in; and high-volume hospitals that lacked leadership support but had appropriate workload and sufficient time for implementation rollout.
conclusionsSuccessful ERP implementation varied by local context and relied on organizational readiness to change, strong staff buy-in, appropriate workload, and sufficient time.
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