Exemplary Overnight Care in the ASC

As all of you know the big winter patient volume has not gone back to the calmer spring and summer census. This can put an incredible stress on our system and I know you all feel the pressure every day. While you may be familiar with many of our strategies from holding in the Emergency Department to our inpatient “two discharges by noon”, you may not be so familiar with the excellent work happening in the Ambulatory Surgery Center (ASC).

Monday through Thursday every week, the ASC is prepared to keep up to four patients overnight in the Post Anesthesia Care Unit (PACU). These patients are carefully selected by the nursing management team and the surgeons. We started this as interim strategy and it has now become part of our standard work. The ASC has hired permanent staff to provide care overnight for this subset of patients, with the goal that they will be discharged early the next morning.

An incredible group of interdisciplinary staff have worked together to create a wonderful patient centric environment. The patient satisfaction with this area is outstanding. Patients who have had surgery here before actually prefer to stay in the ASC PACU. The physicians also prefer the continuity of care because they can check on their overnight patients early in the morning and then go right to the ASC OR to start the early cases thereby improving OR start times. They have a very special Nursing Assistant in this area who demonstrates CICARE in an amazing way. She makes sure that everything a patient needs to have a positive experience is preplanned. One small example; patients food is often sent to the PACU in packaged containers on a tray.

Hella Von Steht, Nursing Assistant ASC PACU

Hella Von Steht has worked with dietary to make sure she has a supply of dishes from the kitchen and she plates the food right before serving it to her patients. What we thought would be a temporary strategy has turned into a permanent solution and Stanford Health Care nurses and nursing assistants make it work so well that patients and doctors request for their patients stay in the ASC PACU overnight – what a great statement of the exemplary professional practice that just happens every day (and night) right here at Stanford Health Care …one patient at a time.



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