Project Details
About the Project
The concept of a Block Room for regional anaesthetic is not new in Victoria: It’s been a successful and impactful piece of work at the Royal Jubilee Hospital for a few years, to the point that the demand almost exceeds capacity. Patients, surgeons, surgical services, and managers are realizing the potential and value of this novel approach to anaesthesia.
Taking learnings from the rollout at RJH, Dr. Jacques Smit has been working to bring a similar service to Victoria General Hospital. SIFEI funding has enabled him to chip away at many of the behind-the-scenes changes necessary for this transformational shift towards more efficient, streamlined care for surgical patients: Identifying suitable procedures and patients to trial the service, developing anaesthesia protocols, securing physical space, bringing on a dedicated Block Room nurse, upskilling Anesthesia Assistants, and ensuring strong communications among all team members.
With the key requirements in place, the team created trial runs in 2025, which revealed a surprising challenge: Geography. When patients arrive at VGH for their surgery, their first stop is Surgical Day Care on the main floor of the building. After being readied, they are taken to the block room on to receive their anaesthetic service. From there, they are transported to one of two operating rooms, which are on different floors of the hospital. Post-surgery, they are taken either to the Post-Anaesthesia Care Unit (PACU) or Surgical Day Surgery to recover. The logistics around timing, coordination and safe patient movement is already notable for any surgical case, made even more challenging at VGH by having ORs on different floors. The role of the block room in this process is essential: “Once a patient is blocked, there is about 30 mins of critical time that they need to be monitored for complications. You have to be able to respond to it.” As shared by Dr. Smit, “That geographical challenge is something we’re learning constantly to improve.” SIFEI funding makes a big difference to bringing people together to have those problem-solving conversations.
The first week of September 2025 saw a limited rollout of the VGH Block Room, with the ongoing, slow addition of services. Just four months later, the team at VGH is seeing benefits:
- Even for some complicated outpatient limb and breast surgeries, the use of regional anaesthetic means that many patients can bypass going to the PACU, an already limited resource.
- For block room patients who do need to go to the PACU, they have a shorter length of stay thanks to the avoidance of opioid anesthetics, which have a longer recovery time.
- A more efficient flow of fewer patients through the PACU has led to reduced PACU blockage with fewer resulting surgery cancelations.
As the Block Room becomes a more known service at VGH, the team continues to work through issues such as pre-op education, team communications, and patient movement. Dr. Smit is certain that, “Once everyone – surgeons, anaesthetists, PACU, Surgical Day Care – is used to the pathway and is on the same page, we’re going to have a much more efficient system.”
There is huge potential for regional anaesthesia in Victoria: From sharing pre-developed protocols between the two sites to developing new ones, the hope is that “if a patient is booked for a procedure at RJH or VGH, they would get the same treatment at either site.” Regional anaesthesia exemplifies the IHI Quadruple aim: It offers a better perioperative experience for patients, is more efficient and appropriate than traditional anaesthesia for some procedures, is less expensive for the system as a whole, improves the physician experience. We’re delighted that it is making such an impact in our community.
Sincere thanks to Dr. Smit and the VGH perioperative care teams for their ongoing work to bring the benefits of regional anaesthesia to Victoria’s health care system.