Interprofessional collaboration in surgical setting during the implementation of a multimodal analgesia protocol: A qualitative study

Abstract

Introduction

The Enhanced Recovery after Surgery (ERAS) program has been a turning point for healthcare professionals and patient's surgical units. To optimize patient relief, a new multimodal analgesia (MMA) protocol was deployed. Implementing this protocol required several professionals, with their roles and interactions emerging as key factors to explore.

Objective

The aim of this qualitative study is to describe the interprofessional collaboration (IC) process during the MMA protocol implementation with surgical healthcare professionals.

Method

A secondary analysis of data from a descriptive qualitative study was conducted. A total of 71 participants, including registered nurses, assistant nurses, managers/educators, residents, surgeons, and pharmacists, took part in semi-structured interviews. Emerging ideas were synthesized using thematic analysis (Braun and Clark, 2006) and then categorized based on constructs defined by the Sunnybrook framework (McLaney et al., 2022).

Results

Several subthemes emerged from secondary analysis: professional roles, interprofessional communication, beliefs, interprofessional trust, interprofessional influence, and nurse autonomy. The protocol implementation fostered role clarification, more efficient and relevant communication, highlighted interprofessional values and ethics, and shared decision-making.

Benefits

Three emerging findings from this analysis: the importance for professionals of having a shared vision, the need for effective and relevant communication, and the importance of fully occupying professional roles.

Conclusion

Successful MMA protocol implementation relying on IC could optimize pain management for surgical patients in ERAS trajectories. The ERAS program optimized post-surgical pain management, with successful MMA implementation relying on IC. This analysis highlights the importance of involving all relevant professionals in complex interventions like post-op pain relief to maximize outcomes.