1 6 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • J U L Y 2 0 1 7
M
any patients spend
more time in
PACU than should
be necessary, but with
improved communication —
and a little detective work —
you can get the number of
lingerers down to a much
more manageable level.
That's what we did. A cou-
ple of years back, we set a
goal of having 80% of our
patients discharged within 2 hours after they were admitted to PACU. It
was an ambitious goal, considering our success rate at the time was
about 13%. And we knew that 2-hour discharge simply isn't a realistic
goal for some patients — those who are diabetic or elderly, for example.
But we began to analyze what was causing so many delays for oth-
ers, and we quickly found some common themes. Most had to do with
pain management, sedation, PONV, voiding issues and other miscella-
neous communication gaps.
An example of a communication problem: A surgeon would write a
prescription for Percocet. But then in PACU, the patient would wake
up and tell us Percocet didn't really work for her, and she wanted
something else. So we'd have to wait for the surgeon to come back
out after his next surgery to get that situation resolved.
Situations like that are relatively easy to prevent. We now have an
organized huddle before each patient leaves the pre-op holding area.
The goal is to make sure the surgeon, the patient, the anesthesia
provider and the nurses are all on the same page. Involving patients is
Clearing the PACU Logjam
• ON THE MOVE Improved communication and detective work helped us
get patients out of PACU faster.
Ideas Work
That
