Developing and implementing a multidisciplinary perioperative education programme to support Enhanced Recovery After Surgery in resource-constrained public-sector hospitals

BACKGROUND: Implementation of Enhanced Recovery After Surgery requires coordinated multidisciplinary practice change and remains challenging in resource-constrained health care settings because implementation barriers often extend beyond knowledge deficits. This article describes the development, implementation and implementation-focused evaluation of a multidisciplinary perioperative education programme designed to support Enhanced Recovery After Surgery implementation across two public-sector hospitals in India. METHODS: The programme was developed through a sequential, evidence-informed process. Findings from a prospective observational evaluation and a sequential explanatory mixed-methods study were synthesised and mapped to the Enhanced Recovery After Surgery Society Guideline for Perioperative Care in Elective Colorectal Surgery and overarching Enhanced Recovery After Surgery principles. This informed the development of a workflow-integrated educational programme incorporating orientation sessions, micro-training, bedside coaching, structured communication, nursing and clinician champions, bedside checklists, visual reminders and audit-feedback. RESULTS: The programme was implemented across a tertiary teaching hospital and a district hospital. Educational activities were embedded within routine perioperative workflows, promoting multidisciplinary engagement, behavioural reinforcement, workflow integration and adoption of standardised recovery practices. CONCLUSIONS: A structured, evidence-informed educational strategy integrated within routine clinical workflows provides a practical approach to supporting sustainable Enhanced Recovery After Surgery implementation in resource-constrained public-sector hospitals.