In our PACU the statistics show that the most often used delay codes are for 'bed not ready' and 'post recovery lounge (phase 2) full '....we have the same issues: late discharges upstairs in the surgical wards,declassification delays of step down pts,certain units 'sitting' on beds (we have a distrust relationship here as well, and some floors are more notorious than others for playing with the truth: "Oh yes,we called housekeeping to have the bed cleaned" to be told by housekeeping when we called to double check,that they hadn't been called!)
What has just been implemented here is an Extended Observation Unit,across the hall in our PACU B (which we don't have enough RNs to open!). One experienced RN (not PACU trained) and one experienced LPN run it 9-5 M-F. When a (non StepDown) pt is ready to be discharged from PACU but their floor bed (or lazy boy chair in phase 2) is not ready,we give report to the Extended Obs RN where the pt is monitered until the receiving unit is ready to take them.We're really hoping this improves our flow. Curiously though,they haven't had a lot of work since this began in May! We're hoping it proves useful and becomes permanent though.
We still have our share of ORs on hold due to cases not being ready for discharge.Usually when too many theatres are trying to empty at 1500!
Yes, on the odd occasion,we absolutely have to send a pt "right now"
-though this is the exception and not the rule. We find it's best to tread lightly,be diplomatic,and be aware that the floor nurses are often terribly
short staffed and run off their feet. If all else fails,we won't hesitate to call the Bed or Nursing Coordinators and get them involved.
Btw,does ASU stand for (Something) Surgical Unit? Not familar with the acronym