Evolution of postanesthesia care units: a legacy of politics, funding, and patient safety concerns

Postanesthesia care units or PACUs (earlier called recovery rooms) flourished after World War II as social, political, and economic influences advanced enormous changes in health care expectations and delivery in the United States. Innovations in science and technology, facilitated by increased federal funding of scientific research in the years preceding and during the war, heralded a postwar need for greater complexity of hospital care safely delivered by trained personnel. PACUs began to open in new and modernized postwar hospitals as a means to safely provide more complex postoperative care during a time of persistent nursing shortages. PACUs proved to be an effective and cost-efficient means of decreasing the significantly high incidence of contemporary postoperative morbidity and mortality. Continuous and skilled observation by the recovery room nurses was credited with the improved patient outcomes. Once firmly established, PACUs have remained vital to the delivering of safe and cost-effective postoperative and postprocedural care.