In 2024, Kaiser Permanente Vallejo Medical Center’s Perioperative Department launched the Phase 2 Project, a collaborative initiative aimed at improving efficiency and enhancing the patient experience in outpatient surgeries utilizing Local MAC or regional blocks. Through teamwork and innovation, this project focused on reducing the length of stay (LOS) in post-anesthesia care units (PACUs), achieving remarkable results. The team is led by Peggy Shen, RN SNIII, Roy Domingo BSN, RN, SNIII, Grace Prado-De Leon, BSN, RN SNIII, Laurence Borja, RN, Adriana Torres MSN, RN, CCRN, CNL, CPAN – PACU ANM, Emily S. Velicaria BSN, RN, CNOR – OR ANM, Kathleen Rose Littlepage, MSN/MBA(c), BSN, RN – PACU/Recovery Manager and Jonathan Khersonsky, MD – Anesthesiologist).
The process was developed through close collaboration among pre-op nurses, anesthesia teams, PACU staff, and leadership to streamline workflows and improve communication. Patients meeting specific criteria for Phase 2 care could move directly to the discharge zone, bypassing unnecessary steps while ensuring safety. The initiative also introduced tools like PASS scores to assess patient readiness, ensuring only those fully prepared were fast-tracked. This approach reduced the average length of stay from 87 minutes to 61 minutes, aligning with national benchmarks recommended by the Journal of Peri Anesthesia Nursing Best Practices and Kaiser Permanente’s regional standards of 60–90 minutes.
Key to this success was the communication and in lockstep within the perioperative team, where each role—from pre-op to PACU—was integral to identifying eligible patients and maintaining seamless transitions. The Fast Track Process excluded cases involving general anesthesia or complex needs to prioritize patient safety and maintain high standards of care.
Looking ahead, patient feedback collected during post-op calls will further refine the process, gauging satisfaction with discharge timelines and ensuring the approach meets patient needs. This aligns with previous successful initiatives like the Lap Chole project, reinforcing the department’s commitment to continuous improvement.