PACU Operations & Workflow

Novia Solutions placed an Interim Director of Perioperative Services at a 120-bed acute care hospital which is ranked as a U.S. News and World Report Best Hospital for 2014-2015 as well as being named as a 2014 Leapfrog Top Hospital.

The Challenge

The PACU area did not have a recovery room manager which created internal conflict, staff attendance issues and lack of consistency in the department. In addition, floor nurses were reporting several incidents/week of lack of pain management for patients discharged from PACU.

The Approach

Novia’s Interim OR Leader used several techniques to increase communication, resolve conflicts, and improve staff and patient satisfaction.

First, our Interim Leader scheduled regular staff meetings and created an open forum to discuss and resolve conflicts. This provided an opportunity share examples of how a situation could be handled to improve problem resolution, minimize conflicts and improve rapport and morale amongst the staff.

Next, our Interim Leader conducted daily rounds to meet with direct reports to purposefully understand the challenges staff were facing and the obstacles creating barriers to their ability to efficiently do their job. For example, a key barrier to staff success was technical glitches with the computer charting program. Eventually, staff gave up, stopped reporting the problem, and tried to figure out workarounds. Through the purposeful daily rounds, this ongoing problem was discovered and fixed, and timely and frequent follow up occurred to ensure it remained fixed and staff felt supported.

Novia’s Interim OR Leader used several techniques to increase communication, resolve conflicts, and improve staff and patient satisfaction.

In addition, our Interim Leader shared activity and productivity reports with staff to increase collaboration between management and staff related to the department’s efficiency and effectiveness.

Our Interim Leader also investigated the incident reports from floor nurses to determine the cause of pain management complaints from patients discharged from PACU to the general floor.

The Solution

Novia’s Interim Leader spearheaded efforts to improve morale by facilitating increased collaboration and communication with in the unit. As a result, the staff came up with a team pledge that everybody signed which gave the unit a fresh start. It was also posted to provide a daily reminder of each individual’s commitment to collaboration and teamwork. The staff expressed appreciation that their concerns were heard, responded to and addressed.

Bottom Line Results

  • Increased employee satisfaction nearly 30%
  • Improved teamwork and morale
  • Reduced pain management incident reports to zero

To resolve the concern regarding patient pain management, Novia’s Interim Leader investigated to find out how PACU nurses were giving pain meds and checking on patients’ response to pain relief. The Interim leader provided additional education to improve awareness and understanding of the therapeutic role of pain management in the patient’s healing process and reduce the concern that narcotic addiction would become a prevalent unintended consequence since its use was short-term.

Once these changes had been instituted, a PACU manager was hired to maintain stability and continuity.


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