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Innovations in Post-Perioperative Care: Redesigning PACU for Enhanced Patient Progression

We’re always looking for innovative ways to optimize our resources — supplies, space, and people— to deliver quality care without overburdening our team members.  One complex issue hospitals face nationwide is throughput, or bed capacity management, which refers to how patients are moved through a hospital, from admission to discharge, while receiving the care they need. At UVA Health University Medical Center, our PeriAnesthesia team has been hard at work on an innovation to help address this issue.

The team has identified several new strategies to maximize the Post Anesthesia Care Unit (PACU) Extended Stay space to avoid overcrowding and underutilization, support team members, and improve patient outcomes. The ideas proposed by this team leverage existing space for:

  • Efficient and effective treatment for applicable post-procedural patient populations
  • Improved care delivery and throughput of surgical patients
  • Streamlined resource usage and care coordination
  • Additional inpatient overflow capacity (ED boarding) overflow staffed by Staffing Resource Office (SRO), ‘day board’ postoperative patients waiting for inpatient beds
  • Mitigating or reducing inpatient capacity impacts by increasing postop patient populations served (Ortho joint same-day surgery patients)

Fast Tracking and Extended Stay PACU Expansion

This team asked, “How can we care for patients who are appropriate for same-day discharge but may require up to a 23-hour postoperative extended stay?” The answer? Instead of moving these patients from the Operating Room to the PACU and then to the inpatient unit, have them recover comfortably in a dedicated PACU space before transitioning between post-anesthesia care and home.

We piloted this expansion with select orthopedic joint patients, a high-volume, but stable and low-acuity patient population. These patients have a predictable and reliable hospital stay within 23 hours from the time of surgery. Previously, their care was provided on 6 East, but now those inpatient beds are freed up for other patients in need.

Surge Capacity

In collaboration with clinical and support services, the PACU will serve as our surge capacity unit as needed, facilitating the movement of patients from the ED, OR, and other post-procedure areas as inpatient beds become available. This approach could support an additional 30 patients per day during a surge.

Ultimately, our new model aims to deliver the right care, in the right place, at the right time. It’s reassuring to know that more patient beds are available when needed.

I am so proud of this team for being proactive in their efforts to find innovative solutions to existing challenges. By tackling bed capacity management issues head-on, we can enhance our ability to provide high-quality care to more patients in need.

Creative thinking is an important first step in innovation and I’d love to hear your ideas for improvement through the Be Heard Suggestion Box.

Take care and be well,

Wendy