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REPACC
REPACC
A Retrospective Evaluation of Post-operative Alternatives to Critical Care (REPACC)
A Retrospective Evaluation of Post-operative Alternatives to Critical Care (REPACC)
PLAN - Pan-London Perioperative Audit and Research Network
PLAN - Pan-London Perioperative Audit and Research Network
Chief Investigator: Dr Christopher Oddy
REPACC was a project investigating the provision and delivery of enhanced care, a model of care that lies somewhere between HDU and normal wards, such as overnight intensive recovery and post anaesthetic care units (OIR/PACU). The hope was to use this data to make enhanced care services more efficient, reduce pressure on critical care beds, and prevent unnecessary surgical cancellations.
Objectives
To describe the current models of enhanced care operational within the UK.
To identify the structural and organisational factors associated with rate of on-the-day cancellation due to lack of an enhanced care bed space.
To evaluate the effect of different models of enhanced care on wider measures of organisational efficiency.
You can find more information here.
Summary of results
Summary of results
Data were collected from 110 participating centres between September and November 2023.
70/110 centres had a surgical level 1 enhanced care unit, suggesting that enhanced care services are already widely established within UK peri-operative pathways.
Of 5990 patient referrals to levels 1–3, 3146 (52.5%) were referred to level 1 and 2844 (47.5%) to levels 2–3.
Patients referred to enhanced care were generally younger, had fewer comorbidities and underwent less complex surgery than those referred to critical care.
Referral to level 1 rather than levels 2–3 was associated with a reduced likelihood of cancellation, cancellation due to a lack of bed, and a shorter hospital stay.
Enhanced care services provide a suitable alternative to critical care and are associated with improved organisational outcomes; however, this should be interpreted in the context of differences in patient acuity and case selection.
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