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Completed

NCT Number: NCT04717089

Extended Post Anaesthetic Care in PACU During COVID-19: Multi-perspective Value-based Analysis

To evaluate the value-based effectiveness of the implementation of TMH Extended post anaesthetic care in PACU during COVID-19 pandemics by an institutional matched case-control and quantitative survey study Two ordinary recovery beds were converted to an overnight intensive recovery ("Extended post-anesthetic care in PACU") within the operating theatre complex of Tuen Mun Hospital during COVID-19 pandemics, in an attempt to free the ICU bed and resources from postoperative patients. This study was designed to evaluate the efficacy and staff perceptions towards the abrupt implementation of TMH extended post-anesthetic care in PACU by mobilization of the existing OT resources to cope with the COVID-19 emergency situations. The value-based analysis would look into the implementation effectiveness in twofold: 1) the clinical efficacy using a case-control audit on clinical outcomes and 2) the staff acceptance by means of the staff attitudes survey. Hopefully, this would provide a multi-perspective evaluation of the implementation strategies and aid planning of new services in the future.

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Key information

Conditions

Overnight Intensive Recovery Postoperative Care

Age range

18 year and older

Sex eligibility

All sexes

Study type

Observational

Primary location

Tuen Mun Hospital

New Territories, Hong Kong

About this study

2 parts are included in this study

The Matched Case-Control study, with the aim of analyzing the clinical efficacy of TMH Extended post-anesthetic care in PACU during COVID-19 in a value-based healthcare model. We included all postoperative patients admitted in TMH Extended post-anesthetic care in PACU during COVID epidemics, excluding patients awaiting ICU in the ordinary recovery room or patients requiring level 3 intensive care on arrival in the recovery room. Three activation periods of 水xtended post-anesthetic care in PACU service (10 Feb - 26 Apr 2020 / 27 Jul - 13 Sep 2020 / 14 Dec 2020 - 28 Feb 2021), and performed case matching with the postoperative patient with similar clinical characteristics entering intensive care unit directly in recent 10 years, with each case matched with specifically 5 control. We evaluate the value-based health care efficacy, including the amount of healthcare expenditure based on bed occupancy and manpower, rate of elective discharge to intensive care unit from extended post-anesthetic care in PACU, rate of unanticipated intensive care admission within 48hrs upon discharge to the general ward, and length of hospital stay, and the total number of ICU bed spared.

The staff attitude survey, with the aim to investigate the staff perception towards the implementation of TMH extended post-anesthetic care in PACU during COVID-19 pandemics based on the Technology Acceptance Model in healthcare. We designed a questionnaire based on Technology Acceptance Model, and distributed it to medical and nursing staff involved in extended post anaesthetic care in PACU service, and evaluate the perceived usefulness, perceived ease of use, social influence of subjective norm, and perceived behavioral control of facilitating condition. A differential analysis would be conducted for the evaluation.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criterion:

o Postoperative patients admitted to TMH Extended post anesthetic care in PACU during COVID-19 pandemics

Exclusion criteria

  • Patients awaiting ICU admission in the ordinary recovery room
  • Patients requiring level 3 intensive care on arrival at the recovery room

Treatment and study plan

overnight intensive recovery / extended post anaesthetic care in PACU

Other

From January 2020, during COVID-19 first pandemics in Hong Kong, a bundle of interim measures was implemented with the joint efforts of the Department of Anaesthesia and Operating Theatre Services (A&OT) and Intensive Care Unit (ICU), and two ordinary recovery beds were converted into extended post anesthetic care in PACU (ExRR), based on the concept of overnight intensive recovery (OIR) to provide level 2 intensive care to patients undergoing major or ultra-major operations or having multiple comorbidities warranted intensive care in the immediately postoperative periods. This was conducted over 3 pandemic waves in Hong Kong.

Primary outcomes

  1. total number of ICU bed days spared

    Time frame: during study period, up to 1 year

Secondary outcomes

  1. amount of healthcare expenditures based on bed occupancy and manpower

    Time frame: during study period, up to 1 year

  2. number of unanticipated intensive care unit admission within 48 hours upon discharge to general ward

    Time frame: 48 hour

  3. rate of elective discharge to the intensive care unit

    Time frame: After extended post anaesthetic care in PACU service by case. Up to 24 hour

  4. length of hospital stays

    Time frame: during admission or patient death, typically up to 1 month

Sponsors and collaborators

Lead sponsor

Tuen Mun Hospital

Other Gov

Collaborators

  • Anaesthesia & Operation Theatre Service, Tuen Mun Hospital, Hong Kong
  • Intensive Care Unit, Tuen Mun Hospital, Hong Kong

Registry information

Official study title

The Rapid Conversion of Ordinary Recovery Beds to an Overnight Intensive Recovery (OIR) to Alleviate the High Pressure on Postoperative Intensive Care Demands During COVID-19 Pandemics in a Local Tertiary Hospital: a Multi-perspective Value-based Analysis

Important dates

Study start
2020
Primary completion
2021
Study completion
2021
First posted
Jan 20, 2021
Registry last updated
Jun 28, 2023

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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