A Royal Adelaide Hospital (RAH) initiative known as Advanced Recovery Room Care (ARRC) is going from strength to strength, highlighting the vital role of early investment in targeted, evidence-based optimal clinical care.
The ARCC team recently celebrated the programs’ third birthday, having first started at Central Adelaide Local Health Network (CALHN) in May 2021.
“Our most recent data indicates ARRC has saved lives, and opened up hospital capacity at the RAH,” says Guy Ludbrook, Professor of Anaesthesia at the RAH and ARRC lead.
“Economic analysis also reveals a cost saving to the hospital.”
In the ARRC model, patients are closely monitored for 12-24 hours after surgery by a diverse team of specialised doctors, nurses, and physiotherapists.
The ARRC team applies a precisely-administered model of care, including extensive guidelines and procotols, more frequent ward rounds and observation, and use of technology such as bedside echocardiography (heart monitoring) to optimise care.
Professor Lubrook’s team won the Enhancing Hospital Care SA Health Award in 2023 with ARRC.
Replicated by national and international hospitals
The success of the RAH’s ARRC approach has attracted national and international attention.
“Initiatives like the ARRC were acknowledged as part of the future of anaesthesia in a national annual keynote address, the Rovenstein Lecture, in October 2023 in the USA,” Professor Ludbrook says.
ARRC has been replicated at the Peter MacCallum Cancer Centre in Melbourne, and a pilot is opening at a hospital in Hamilton, New Zealand in mid-2024.
“Here at the RAH, we recently welcomed a delegation of six doctors and nurses from the Prince of Wales Hospital in Hong Kong, as they are planning to implement the ARRC approach as well,” says Professor Ludbrook.
“We’re also collaborating with clinicians in the Netherlands on ARRC development.”
Supporting further quality improvement, ARRC implementation at the RAH now has a registry of over 2000 patients, which aids in identifying and defining key risk-adjusted clinical indicators for the future.
“We plan to formally study introduction of a Stage II of ARRC, where some patients whose early recovery has exceeded expectations will need less high acuity care overnight, with added safety provided through remote monitoring,” Professor Ludbrook says.
“This has obvious potential benefits to both patient comfort and hospital capacity.”
Funded by CALHN and other sources
Funding for the first phase of ARRC was provided by a competitive research grant from CALHN’s Clinical Rapid Implementation Project Scheme (CRIPS).
It was also supported through the Health Services Charitable Gifts Board, and internal resources from CALHN’s clinical trials unit, PARC Clinical Research, and the Australian and New Zealand College of Anaesthetists.
Read the research
Professor Lubrook has published two papers on the impact of ARRC:
- The Cost-Effectiveness of Early High-Acuity Postoperative Care for Medium-Risk Surgical Patients
- Cost-Effectiveness in Perioperative Care: Application of Markov Modeling to Pathways of Perioperative Care
The 2023 Rovenstine Lecture was published in Anesthesiology.
