TITLE: THE EFFECTIVENESS OF A FAST TRACK POST ANESTHESIA CARE UNIT COMMITTEE IN THE OUTPATIENT SETTING

AUTHORS: Peter J. Lee, MD, Linda Yang, BS, Jeremy Lieberman, MD
AFFILIATION: University of Michigan Medical Center, Ann Arbor, MI.

INTRODUCTION: The goals of the fast-track post-anesthesia care unit (FT-PACU) are to recover patients safely, efficiently and rapidly in the ambulatory setting. A FT-PACU committee could initiate protocols and educate physicians and nurses to achieve their goals. We hypothesize that establishing a FT-PACU committee will decrease PACU length of stay.
PURPOSE: The purpose of this study was to compare time in PACU (phase 1, phase 2, and total PACU time) both prior to and after a FT-PACU committee was established (3/98).
METHODS: Data was collected from April 1997 to February 1998 (period 1) and March 1998 to May 1999 (period 2) from the operating room database. Outpatient knee arthroscopy, inguinal hernia, and urology cases were identified. Subarachnoid block (SAB) and general anesthesia (GA) cases were evaluated sep- arately.
RESULTS:

Patient demographics and surgical duration were the same for the two time periods. PACU length of stay decreased significantly (*p<0.05) for hernias done under SAB, and for knee arthoscopy and urology procedures done under GA.

DISCUSSION: Prior to establishing a FT-PACU committee, the average PACU stay for hernia repair cases, knee arthroscopy cases and urology cases for both SAB and GA was over three hours. Establishing a FT-PACU committee including surgeons, anesthesiologists, and PACU nurses led to reduction in PACU times for several different outpatient procedures. The committee suggested preferred intra-operative management guidelines and revised discharge criteria. The simple intervention of establishing a committee to enhance efficiency may be a cost-effective method for decreasing PACU length of stay. Further interventions may continue to reduce recovery time.
REFERENCES:

1.) Anaesth 94: 841-2 (1994).

2.) J of Clin Ans 8: 705-725 (1996).