title: Strategies to maintain operating room functionality following the complete loss of the recovery room due to an internal disaster.
abstract: The post-anesthesia care unit (PACU) is a major contributor to the operating room (OR) process flow and efficiency. A sudden failure of hospital facility infrastructure due to a burst pipe resulted in the complete loss of a 66-bed combined preoperative and PACU facility of a major academic medical center. The OR suites were undamaged. The clinical and administrative challenges of caring for surgical patients without the usual preoperative and postoperative care areas are discussed. Our strategy for maintaining OR functions and management of patient flow, OR personnel, case prioritization, and equipment needs are detailed from the time of initial crisis until restoration of these clinical care areas. Utilization of the hospital disaster Incident Command Structure and the activation and decision support provided by the hospital Emergency Operations Center (EOC) for the week immediately following the crisis, helped maintain OR functionality.
authors.affiliation: Instructor of Anesthesiology, Harvard Medical School, Brigham and Women's Hospital, Department of Anesthesiology, Perioperative and Pain Medicine, Boston, Massachusetts.
authors.forename: Elise C
authors.initials: EC
authors.lastname: Metzler
authors.affiliation: Associate Professor of Anesthesia, Harvard Medical School, Brigham and Women's Hospital, Department of Anesthesiology, Perioperative and Pain Medicine, Boston, Massachusetts.
authors.forename: Bhavani S
authors.initials: BS
authors.lastname: Kodali
authors.affiliation: Assistant Professor of Anesthesia, Harvard Medical School, Brigham and Women's Hospital, Department of Anesthesiology, Perioperative and Pain Medicine, Boston, Massachusetts.
authors.forename: Richard D
authors.initials: RD
authors.lastname: Urman
authors.affiliation: Assistant Professor of Anesthesia, Harvard Medical School, Brigham and Women's Hospital, Department of Anesthesiology, Perioperative and Pain Medicine, Boston, Massachusetts.
authors.forename: Hugh L
authors.initials: HL
authors.lastname: Flanagan
authors.affiliation: Instructor of Anesthesiology, Harvard Medical School, Brigham and Women's Hospital, Department of Anesthesiology, Perioperative and Pain Medicine, Boston, Massachusetts.
authors.forename: Monica Sa
authors.initials: MS
authors.lastname: Rego
authors.affiliation: Instructor of Anesthesiology, Harvard Medical School, Brigham and Women's Hospital, Department of Anesthesiology, Perioperative and Pain Medicine, Boston, Massachusetts.
authors.forename: Joshua C
authors.initials: JC
authors.lastname: Vacanti
mesh_terms: D001900:Boston; D004190:Disasters; D055868:Floods; D006784:Hospitals, Teaching; D006801:Humans; D009873:Operating Rooms / Q000458:organization & administration*; D016528:Postanesthesia Nursing / Q000458:organization & administration; D011997:Recovery Room / Q000458:organization & administration*