A study in time: performance improvement to reduce excess holding time in PACU.

The early 1990s saw prolonged patient stays in the PACU at St Joseph's Hospital of Atlanta, a 350-bed tertiary-care hospital. PACU discharge was delayed for various reasons: no room available, no receiving nurse, no help to transport patients, and prolonged recovery from anesthesia. These prolonged stays resulted in occasional backups in receiving patients from the OR, as well as having alert patients among arriving patients, unstable patients, and patients with nausea or pain. These delays were perceived to be stressful to the patient, their families, and to the staff. It was also expensive for the patient and costly in terms of nursing care. A multiyear, intermittent study was conducted to seek and implement solutions to this problem and evaluate the results. This article details these efforts and the resulting accomplishments.