Table 3.

Challenges faced during ERP testing.

Challenge		Solution
Staff education	Training initially provided to nursing staff was inadequate as evidenced by confusion over which preoperative medications to provide	Provide more detailed staff training prior to formal launch
		Conduct ongoing staff education throughout implementation of the ERP
Family education	Inconsistencies between education provided verbally to families and education provided in handouts	Education handouts were revised prior to the formal ERP launch
	First preoperative education session was done virtually where the educator only spoke directly with the parent. This required sending the educational handouts through the electronic medical record portal	Conducting education sessions in person or scheduling a video call only when the caregiver and patient will both be present
Tracking adherence to ERP procedures	The process for alerting nursing staff, oncology team, pharmacy, and consulting services about scheduled ERP patients was disorganized	Create an email group of ERP champions in each clinical area and send out an email to alert them prior to each ERP patient surgery
	Adherence to ERP procedures was difficult to determine as there was no tracking system for this purpose	Create an ERP-specific dashboard in the electronic medical record that tracks adherence outcomes