Table 2.

Key principles to guide patient engagement in ERAS

Guiding principle	Description
1. ‘One size will not fit all’	No single step-by-step process or ‘model’ for patient engagement can be developed. There is a need to recognise the different cultures and contexts within which ERAS is being implemented; the reality that patients will have different preferences regarding how they want, or are able, to be involved at every level.
2. Wherever possible, build on existing mechanisms for capturing, analysing and disseminating patient/family feedback.	This approach will avoid unnecessary duplication of effort and will be more cost-effective. It is recognised, however, that new data collection, analysis and dissemination approaches may be required.
3. Experiences from a broad cross section of patients should be sought.	Patients with either very poor or very good experiences, and those with greater resources, are more likely to provide input. In order to capture a broad range of experiences, it is important to identify and address barriers to participation wherever possible.
4. Not all illnesses or surgeries are the same, so it may be important to identify subgroups of patients that may have some unique issues.	Although there will be some commonalities with respect to patients’ experiences with colorectal surgery and ERAS, there may also be differences. For example, patients with inflammatory bowel disease may have some unique issues and needs compared with those with bowel cancer.
5. Priority should be given to what patients want to tell us, not just what the system wants to hear.	While ERAS personnel have many important questions about patient experiences, it is crucial that patients also have open-ended opportunities to talk about issues of importance to them, issues that may not be anticipated by health professionals.
6. Nursing units and the ERAS programme need to value patient feedback and expertise and be invested in ongoing learning and improvement.	Meaningful patient engagement requires that healthcare professionals be interested in hearing patient feedback and using it to inform changes in practice and policy. Individual health professionals need to be supported by units and facilities that are invested in and provide supports for ongoing learning and improvement.
7. Patients need to know how their input is being used.	Leading in, there is a need to let patients know how their input will be used, and then afterwards it is important to circle back and let patients know the impact of their input.
8. Patient engagement needs to be resourced if it is to be done well.	Patient insights can be a core contributor to changes in policy and practice that will result in more positive patient experiences and better outcomes. Patient engagement must be well resourced in order to optimise its value and contribution.

ERAS, Enhanced Recovery After Surgery.