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PACU fast-tracking: an alternative to "bypassing" the PACU for facilitating the recovery process after ambulatory
Paul F White1, Shivani Rawal, John Nguyen
1Department of Anesthesiology and Pain Management at the University of Texas Southwestern Medical Center at Dallas, 75390-9068, USA. paul.white@utsouthwestern.edu
Abstract:
This retrospective evaluation assessed the impact of discharging outpatients home directly from the PACU as an alternative to "PACU bypassing." A total of 1,380 outpatients who had undergone minor ambulatory procedures were evaluated. Nine hundred fifty-two outpatients were admitted to a designated PACU fast-tracking area to facilitate an earlier discharge. Of the outpatients admitted to the PACU fast-track area, 88% were discharged home within 60 minutes (mean time [+/- SD] of 58 +/- 8 minutes]. The remaining 12% were discharged home from the PACU in an average of 88 (+/- 12) minutes. The recovery times for the 428 outpatients who were initially considered for the PACU fact-tracking program but were admitted to the regular PACU and recovered according to the conventional (two-step) pathway were 38 +/- 25 minutes in the PACU, followed by 61 +/- 32 minutes in the day surgery step-down unit. We conclude that this pilot program demonstrates the feasibility of discharging patients home from the PACU. Only 12% of the outpatients who were admitted to the PACU fast-track area failed to be discharged within 60 minutes. The overall times to discharge from the PACU fast-track area compared favorably to discharge times for outpatients bypassing the PACU. This program provides nurses with an alternative recovery pathway for fast-tracking patients after ambulatory surgery.