In January 2018, Michael Garron Hospital (MGH) launched the merger of its Day Surgery (DS) unit and Recovery Room (RR) into a combined Peri-Anaesthesia Care Unit (PCU). The primary intent of this initiative was to efficiently reduce operating room (OR) delays and patient recovery times through full utilization of an RPN’s scope of practice and bed space reorganization. The initiative’s success demonstrates the advantages of combining two separate units.

Prior to the merger, day surgery patients were moved from the operating room to the recovery room after their procedures, and then finally transferred to the day surgery unit. When the recovery room reached capacity, staff were forced to shut down the operating room to temporarily hold patients for recovery care, and thus were unable to accept new patients or move on to the next scheduled procedure. This caused delays for both patients undergoing surgery and also for their families and/or caregivers. The new PCU has reduced surgical delays due to lack of RR capacity by 79%.

To effectively facilitate the new PCU model and further enhance patient-centered care, a collaborative staffing model utilizing both RN’s and RPN’s was integrated into patients’ early recovery care. Previously, RN’s were staffed in phase one of recovery in the RR, with RPN’s only being involved in the latter stages of recovery in the DS unit. The joint model uses a combined RN/RPN approach, alleviating staffing challenges through a streamlined care pathway, resulting in reductions to overall OR delays and more integrated care for patients.

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