Modified PACU Discharge Process During COVID-19 Pandemic

BACKGROUND INFORMATION: Coronavirus disease-2019 (COVID-19) has become a worldwide pandemic that presented challenges and brought extensive changes in the healthcare delivery. Restricting visitation in peri-operative setting is one of the steps adapted by the institution to enhance safety of patients, families and healthcare workers. This had a great impact on the discharge process in the Post-anesthesia Care Unit (PACU). OBJECTIVES OF PROJECT: Implement a modified discharge process to ensure safe transfer and continuation of care of post-operative patients. PROCESS OF IMPLEMENTATION: Visitor's restriction led to no visitors in perioperative setting except for pediatrics and patients with physical / cognitive limitations. This new process demanded a modified discharge process for outpatients. The two methods used were: • Virtual instruction: Given to family or responsible person by phone before discharging patients from PACU. • Face-to-Face discharge instruction: Provided in one of the four temporary discharge centers created at the entrance to minimize visitation time and exposure to other patients in PACU. Patient families who required one- on -one demonstration and practice identified and escorted to discharge center after COVID screening. Prescriptions for all patients delivered by pharmacy. Copy of after visit summary and patient education provided to family and included in electronic medical record. STATEMENT OF SUCCESSFUL PRACTICE: Successfully implemented the modified PACU discharge workflow in April 2020. Data collected from 4/1/20 to 1/31/2021 shows that 7,409 patients used the modified discharge process. Out of the 7,409, 86% received instruction through phone call and 14% used the discharge center. Press Ganey patient satisfaction rate with discharge remained high at 96%. IMPLICATIONS FOR ADVANCING THE PRACTICE: This project demonstrated the importance of adapting new process to enable safe delivery of care during emergencies. The modified workflow allowed effective transfer of discharge information and patient education for PACU patients while following COVID-19 protocol for visitation. This new model of discharge process can be replicated in similar healthcare environment.