| Sumario: | Significance & Background: ICU patients arrived to their post-op units without reserved beds. This posed a risk to patient safety and burdens nursing staff. Due to those circumstances, the team created a new process that aligned bed and nurse availability. Establishing high-dependency units and tailored care pathways, based on individual patient needs and available resources, enhances patient outcomes and optimizes postoperative care. Purpose: To improve patient safety and streamline ICU admissions by implementing an early bed reservation process coordinated by the Patient Flow team. This initiative was designed to reduce unplanned post-operative ICU arrivals, align nursing resources with patient needs, and enhance communication between perioperative and critical care teams. Interventions: The role of the Patient Flow Coordinator was utilized in a high-acuity ICU with eight beds. In conjunction with our electronic medical record platform, a scheduling report was developed for physicians to easily reserve ICU beds during the procedural planning phase. The report confirmation occurs prior to the procedure, ensuring the availability of beds and staff to care for our patients. Communication between the nurse leaders of the ICU and OR/PACU, as well as the director of inpatient nursing, is vital to safeguard the process of this patient safety practice change. Interdisciplinary education sessions, Epic provider training, and use of workflow prompts supported adoption of the practice change. The Patient Flow team reviews weekly reports, engages nurse leaders for staff planning and feedback for continuous improvement. Results: Pre-implementation: 5-6 unplanned ICU post-op arrivals/month. Post-implementation: 0-1 unplanned ICU post-op arrival/ month over 3 months. ICU nurse staffing aligned with planned caseload, improved satisfaction, and no surgical delays due to ICU bed shortage resulted in the success from implementation of this practice change. Discussion: Improved ICU capacity planning resulted in a reduction of unplanned admissions, thereby enhancing patient safety. Ongoing monitoring of this innovative leading practice supports sustainability. In terms of transferability, the team plans to expand this nurse practice change to step-down units and surgical service lines.
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