Same-Day Surgery Manager

How to get patients out of the recovery room

By Stephen W. Earnhart, MS
CEO
Earnhart & Associates
Austin, TX

Question: Please explain the difference between pushing patients out the door versus letting them become lounge lizards that seemingly have no place to go after their surgery. We are not a hotel here, and I am tired of dragging out the recovery period and getting complaints when the patients or the surgeons say they felt rushed.

Answer: One of the most frequent complaints of surgery centers or hospitals is patients complaining to their surgeon that they feel they were "rushed" or "pushed out" too soon after surgery. In many cases, sad to report, the complaints have merit. But, here are some clues to reducing the patient stay and also eliminating many of the complaints:

  • As soon as the patients are able to understand you when they come into the recovery room, tell them exactly what the process will be for discharge. Explain to them that they can expect to spend up to 30, 45, or 60 minutes (or whatever time) in the recovery room before they can go home. Set that expectation right from the start.
  • Let the patient's family in to be with them as soon as possible. Nothing gets old quicker than watching a family member drool, complain about everything, or just sleep. The family members will come to you and ask when they can get out of there.
  • Get rid of the TV. If that is not an option, set the channel to the "Home Shopping Network" or some infomercial about a juicer or some silly thing. Don't let them get involved in a sitcom or soap opera.
  • Avoid giving carbs as a snack. They put me to sleep, and they probably do the same for most others.
  • Avoid conversations other than superficial chitchat. You do not want a political debate on your hands.
  • All your activities with the patient and their family should be purposeful. Every time you interact with the patient, there should be a reason for it, and you should explain what it is.
  • Make sure that all interaction with the patient is positive. Most complaints come from patient (or their irritating family members) if they perceive (PERCEIVE — not based upon REALITY) that you have been rude or "short" with them.
  • Make believe to yourself that you are a waiter or waitress at a restaurant, and suck up to them just before they are discharged. Hey, it works.
  • Have their surgeons stop by their beds as soon as possible after surgery. You don't want them to wait until the end of their scheduled cases to "visit" with the family.
  • Plant the seed in the family members head about how hungry you know they must be getting and "I wish we had something to feed you" so they will help push the patient out the door so they can go out for a late lunch.
  • Avoid having recent magazines in the area. Nothing spells boredom and "get me out of here" quicker than nothing to read.
  • Encourage other staff members to walk by the patient's bed frequently and make comments like, "Wow, are you still here?"
  • Test the alarms repeatedly on the monitors near the patients.

All joking aside, every facility is only as fast as its slowest patient — or surgeon. Avoid as much as possible the situation in which patients are using the recovery area for catching up on their sleep. The surgeons do respond to their patients' complaints (and praise — thought not as often), so be aware of balancing the discharge time against patient satisfaction. (Earnhart & Associates is an ambulatory surgery consulting firm specializing in all aspects of outpatient surgery development and management. Contact Earnhart at 1000 Westbank Drive, Suite 5B, Austin, TX 78746. E-mail: searnhar@earnhart.com. Web: www.earnhart.com.)