How well are prebooked surgical step-down units utilized?

Area of Science:

• Surgical care and patient outcomes
• Healthcare resource utilization
• Postoperative management

Background:

• The surgical step-down unit (SSDU) is a critical resource for managing postoperative surgical patients.
• Optimizing SSDU utilization is essential for efficient healthcare delivery and patient care.

Purpose of the Study:

• To evaluate the actual utilization of the SSDU among preoperatively booked patients.
• To identify patient characteristics and perioperative factors associated with SSDU interventions.

Main Methods:

• Retrospective chart review of 133 elective surgery patients with prebooked SSDU beds.
• Data collected included comorbidities, Surgical Risk Scale (SRS), and Surgical Apgar Score (SAS).
• Analysis focused on SSDU admission rates and interventions during the stay.

Main Results:

• Only 45.1% of scheduled patients were admitted to the SSDU; 54.9% went to the surgical ward or were discharged.
• Of admitted patients, 48.3% experienced an intervention in the SSDU.
• The SRS predicted SSDU use, while the SAS predicted the need for interventions or events.

Conclusions:

• Actual SSDU utilization is lower than planned, with less than half of admitted patients requiring interventions.
• The SAS effectively predicts the need for interventions, guiding resource allocation.
• Developing predictive scores incorporating intraoperative and early postoperative factors is recommended to optimize SSDU resource management.