From Theatre to Ward: Redesigning Postoperative Care in Thoracic Surgery
Care Process & Redesign
National Healthcare Innovation and Productivity Medals
National University Health System
29 January 2026
To improve postoperative care in thoracic surgery patients by transferring them directly to the General Ward instead of the. The intervention successfully reduced the need for HD beds, decreased the length of postoperative stay, and resulted in cost savings.
Year Submitted: 2025
Published Date: 29 January 2026
Tags: Cost Saving, Workflow Redesign, Care Process ＆ Redesign, Quality Improvement, Productivity, Functional Outcome, Value Based Care
About this Content
Aims
To improve postoperative care in thoracic surgery patients by transferring them directly to the General Ward instead of the High Dependency unit, thereby reducing postponements and cancellations of elective major lung surgeries.
Background
Lobectomy patients have traditionally been transferred to the High Dependency unit for postoperative monitoring due to the perceived higher risk of these operations. However, the availability of HD beds is limited and often leads to cancellations of scheduled surgeries.
Methods
The ERATS program was optimized to ensure lobectomy patients do not develop significant postoperative complications and are ready for transfer to the General Ward by POD 1. A workflow was implemented for post-lobectomy patients to go directly to the General Ward on POD 0.
Results
The need for postoperative HD beds was reduced from 48.9% to 10.8%. There was no difference in unplanned returns to OT, HD, or ICU, and no increase in cardiac, infective, renal, or neurological complications. Postoperative length of stay was reduced from 6.8 to 5.0 days.
Conclusion
The intervention successfully reduced the need for HD beds, decreased the length of postoperative stay, and resulted in cost savings, demonstrating the potential for role transformation among thoracic specialty and General Ward nurses.
Lessons Learnt
The redesign of postoperative care for lobectomy patients can lead to significant resource savings and improved patient outcomes without increasing complications.
Additional Information
The reduction of postoperative stay by 1.8 days results in cost savings of ~$3000 per patient, translating to $1.5 million with 500 cases per year.
Keywords
Lobectomy, Postoperative Care, Thoracic Surgery, Cost Savings, Workflow Redesign
Innovators' Details
Innovators' Details
Healthcare Cluster(s) | National University Health System |
Organization(s) Involved | NATIONAL UNIVERSITY HEART CENTRE SINGAPORE |
Platform(s) | National Healthcare Innovation and Productivity Medals |
Healthcare Professional Group(s) | Nursing |
Applicable Specialty or Discipline | Surgery |
Project Lead(s) | JOHN TAM KIT CHUNG |
Project Member(s) | Sister Senbagam |
Connect with this contributor!
Dr CHEN JIANYE - jychenjianye@gmail.com
Project Attachment
418_NUHCS_NHIP_2024_From_Theatre_to_Ward_Redesigning_Postoperative_Care_in_Thoracic_Surgery.pdf