Fast-tracking: Toward a Patient-centered Approach to PACU Bypass

Several scoring criteria have been used to assess patients’ early recovery, including the Aldrete scoring system and its modifications, the Mayo modified discharge score, and the standardized Postanesthesia Care Unit (PACU) bypass/discharge criteria. With the rapid increase in the number of ambulatory surgical procedures and the introduction of shortacting anesthetics, it was recognized that patients frequently meet the criteria for early recovery from anesthesia while in the operating room and before transport to the PACU. Criteria for bypassing phase I recovery (also called fasttracking) were established to identify patient eligibility for PACU bypass, and include the White and Song fast-tracking criteria and the Wake scoring criteria. These criteria, if used by the anesthesia team after the patient emerges from anesthesia, can avoid unnecessary transfer of patients to the PACU if bypass criteria are met and can: