Table 6.

Cognitive participation—supporting quotes

Community of practice	The network of all of the champions from the hospitals has been so instrumental in helping our hospital. The continued ongoing communication with the monthly phone calls for example. The website being fantastic, there’s just been so much support around this. (Nurse)
	The networking and the sharing of resources, I thought that was just absolutely fabulous. The people that were chosen from each hospital I think were really good champions. Very well-rounded, experienced, self-confident, not about, “look what I’ve done.” More like, “this is what we’ve done. Do you want it?”(Nurse)
Engagement strategies	Eventually I just met with several of the more resistant people to get a sense of what their concerns were and whatnot. So we’ve had meetings, we’ve had emails. A variety of different things to get people to buy into it essentially. It’s been a long process of that but eventually people have. (Surgeon)
	I go to most ORs and talk to the anesthesiologists to try and translate and clarify areas and make them understand what compliance with the program meant. (Anaesthesiologist)
Opportunities for co-creation	For me it was very important because it set the stage for partnership, so we had OT, PT, dietician involved. For each section, we had the ET nurses, we had frontline nurses, we also had the charge nurses. It was very very important because I wanted them to have the sense that they developed it. I’ve given you guidelines. How are we going to do it? It was very very important. Better buy-in. (Nurse)
	We got together and formed a work group of all the people who would be involved in implementing the various parts of the guideline. So this group was about 10 people, there was a dietitian, someone from physio, someone from OT, someone from nursing etc. Everyone who would have a stake in or in their workflow being changed and then over the next several months, we looked through the guideline and each piece worked on implementing their own, and me and the nurse person for that would essentially lead those meetings to try to get things implemented. (Surgeon)
Provide updates	I think it was about 3 months ago we got a report and I emailed the department the report and told them what our hospital number was. And then in the email I just mentioned some of the places we need to do a little bit better. (Anaesthesiologist)
	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 or so that we’ve been involved in ERAS so we presented some of the data from the report that we got back. (Nurse)