Fast-Tracking Patients in an Academic Hospital to Increase Efficiency and Decrease Discharge Delays: A Process Improvement Plan

Abstract

PurposeThe purpose of this quality improvement project was to determine if implementing a Phase II postanesthesia care unit (PACU II) to fast-track patients following surgery in an academic hospital would decrease OR hold times and increase patient flow efficiency. DesignAn observational pre-post design was used to compare PACU bypass rates and recovery times for ambulatory surgery (AS) patients before and after implementation of a patient fast-tracking program. MethodsA PACU II was instituted and a fast-tracking program using the White Fast-Track Scoring tool was adopted. Nursing staff as well as anesthesia providers were educated to assess patients using the tool as well as the appropriate patient population to be transferred to the new PACU II. FindingsFollowing implementation of the new unit and the fast-tracking program, a PACU bypass rate of 30% was achieved and there was a significant decrease in PACU length of stay for AS patients. ConclusionsThe results suggest that fast-tracking is a suitable intervention to decrease inefficiencies in an academic setting despite higher acuity patient populations.