The PACU may be unable to admit patients for many reasons; for instance, there may not be enough PACU nurses or bed spaces; patients may be waiting for transport to other units or departments; patients may not be fully recovered from anesthesia; and patients may be waiting for floor, stepdown, or ICU beds. When this happens, the PACU cannot continue to accommodate the flow of the OR schedule, and patients may need to be recovered from anesthesia in the OR under the care of the anesthesia providers. This bottleneck leads to dissatisfaction among the physicians, nurses, and ancillary staff as well as patients and their families (Shoenmeyr et al., 2009). The PACU administrative team may need to make regular adjustments to the unit to accommodate these delays.
Recently, advanced computer modeling has been used for surgery scheduling to optimize patient flow, decrease clinical resource idling, and make it less likely that OR patients would be competing at the same time for a limited number of PACU beds (Lee & Yih, 2014).