Implementation of a direct-from-recovery-room discharge pathway: a process improvement effort. Surg Innov 2009 Sep;16(3):258-65
Date
07/07/2009Pubmed ID
19578054DOI
10.1177/1553350609339169Scopus ID
2-s2.0-70349588327 (requires institutional sign-in at Scopus site) 5 CitationsAbstract
BACKGROUND: The authors describe a process improvement effort to achieve direct-from-recovery-room discharge for elective laparoscopic cholecystectomy patients--without prior patient selection.
METHODS: The authors developed and implemented a new pathway, and then measured the learning curve (ie, success rate over time for direct discharge) and compared patients achieving direct discharge with patients admitted after surgery.
RESULTS: The learning curve between the first patient and steady-state performance was 56 patients. A total of 80% of patients achieved direct discharge. Directly discharged patients were younger (P<.001), had lower ASA physical status classifications (P<.005), and left the recovery room earlier in the day (P<.0001). However, elderly patients and those with high ASA scores frequently could be directly discharged from the recovery room.
CONCLUSIONS: Through small team based rapid cycle process improvement, direct-from-recovery-room discharge of laparoscopic cholecystectomy patients can be achieved in an unselected patient population with a short learning curve.
Author List
Ehrenfeld JM, Seim AR, Berger DL, Sandberg WSAuthor
Jesse Ehrenfeld MD, MPH Sr Associate Dean, Director, Professor in the Advancing a Healthier Wisconsin Endowment department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdultCholecystectomy, Laparoscopic
Critical Pathways
Female
Hospitalization
Humans
Male
Middle Aged
Patient Discharge
Recovery Room
Retrospective Studies