‘The Block Room’: developing a model to enhance the delivery of regional anaesthesia University College London Hospitals (UCLH)

Regional anaesthesia, whereby local anaesthetic is given to a defined region of the body, is traditionally delivered within anaesthetic rooms. It is known to decrease recovery times, decrease post-operative nausea, decrease post-operative pain and increase patient satisfaction when compared to general anaesthesia.

Expertise and time is needed to perform ultrasound guided nerve blocks for regional anaesthesia. It is traditionally delivered within anaesthetic rooms where, due to time pressures and often inadequate skill mix, its delivery is often inconsistent, unreliable and delivered with limited success rates.

This innovative project from UCLH has involved developing a dedicated area – a Block Room – within the theatre complex where regional anaesthesia can be carried out in a more focused, specialised, and therefore reliable and safe, environment. Although Block Rooms have been used in North America for the past decade, UCLH is one of the first UK hospitals to implement such an innovative service.

The Block Room has provided a location for all nerve blocks to be performed, and has also become a hub for training and research.

A series of patient videos have been produced to help explain the Block Room and provide an important patient resource. Patient experience was evaluated through a questionnaire.

The initiative has resulted in an increase in the number and types of blocks being performed at UCLH, and has helped improve theatre efficiency. The Block Room has been well received by hospital staff and patients, and the service has now been embedded within several surgical pathways, including those for breast cancer surgery and orthopaedic hand surgery.

Challenges included a number of changes to operating lists, including timings and locations, which impacted on efficiency and planning for the service. Flexibility in adapting the Block Room has helped to cope with these, including on occasion closing the Block Room to allow staff movement and other operating lists to continue.

This Innovating for Improvement project ran from the beginning of May 2015 until the end of July 2016.

Download

• Poster: Patel S et al, Developing a ‘Block Room’. Improving safety, patient experience and outcome, ASRA 2015.

Contact information

For more information about this project, please contact Dr Sanjiv Patel, Consultant Anaesthetist, University College London Hospitals.