Date of Graduation

Summer 8-7-2022

Document Access

Project/Capstone - Global access

Degree Name

Master of Science in Nursing (MSN)


School of Nursing and Health Professions


Kaiser cohort MSN capstone

First Advisor

Dr. Sara Horton-Deutsch

Second Advisor

Professor David Ainsworth



Problem: The increased patient postoperative length of stay (LOS) is impacting the throughput of the operating room and resulting in prolonged wait time for new post-anesthesia care unit (PACU) admissions from the operating room. The baseline data indicated that average LOS of laparoscopic cholecystectomy patients after surgery was 153 minutes, which is longer than the regional 90-minute standard.

Context: To deliver more efficient care, the healthcare team determined that improving LOS for laparoscopic cholecystectomy patients would increase patient care experience, improve department efficiency, and decrease healthcare cost (Health Catalyst, 2018).

Intervention: The microsystem adopted the continuous improvement methodology to improve perioperative efficiency by standardizing nursing practice and incorporating a systematic, data-driven, and multipronged approach to identify solutions with the maximum possible impact. Rogers’ change theory helped to implement the interventions as it includes five important phases of planned change: awareness, interest, evaluation, trial, and adoption.

Measures: The outcome measure is average postoperative LOS of 90 minutes. The first process measure is percentage of laparoscopic cholecystectomy patients offered oral pain medication in the PACU. The second process measure is the percentage of patients discharged from the PACU instead of being transferred to secondary recovery.

Results: The team was able to meet the 90-minute average LOS target by implementing the practice learned from successful tests of change.

Conclusion: The enhanced recovery program will help patients discharge home faster, resulting in better quality outcomes. Improving and optimizing LOS will lead to positive outcomes by reducing variable costs associated with increased LOS, resulting in increased patient satisfaction, safety, and high-quality care.

Available for download on Sunday, August 04, 2024

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