ABSTRACT
OBJECTIVE: To determine whether patients who have undergone heart surgery can be managed with use of rapid recovery guidelines without any subsequent increase in complication, mortality, or readmission rates. DESIGN: Retrospective study, two groups, comparative. SETTING: Private midwestern hospital with 690 licensed beds. SUBJECTS: Group I consisted of 312 adult patients who had undergone heart surgery in 1993 who were managed using traditional methods. Group II consisted of 303 patients who had undergone heart surgery in 1994 who were managed using rapid recovery guidelines. OUTCOME MEASURES: Complications (pneumonia and wound infections), mortality, and readmission rates. RESULTS: Of the surgeries performed in 1994, 44% of the patients were discharged by postoperative day 4. No increase was noted in complication, mortality, and readmission rates. CONCLUSIONS: When compared to patients who were managed by traditional methods, these findings indicated that it is possible to manage adult patients who have undergone heart surgery using rapid recovery guidelines and maintain high-quality patient outcomes and level of satisfaction. In addition, cost savings and decreased resource use are added benefits.
Subject(s)
Cardiac Surgical Procedures , Postoperative Care/methods , Aged , Cardiac Surgical Procedures/economics , Cardiac Surgical Procedures/mortality , Coronary Care Units , Costs and Cost Analysis , Female , Humans , Length of Stay , Male , Patient Readmission , Pneumonia/etiology , Postoperative Complications , Practice Guidelines as Topic , Preoperative Care/methods , Retrospective StudiesABSTRACT
Despite a strong national commitment to excellence in healthcare, the available resources are limited. Cardiac surgery consumes more healthcare resources than any other single treatment. It is imperative that healthcare professionals evaluate the traditional methods used to deliver quality care. Rapid recovery programs have been implemented in response to this challenge. The purpose of this article is to discuss development, implementation, and outcome evaluation of a rapid recovery program for cardiac surgery patients in a single health center. A multidisciplinary team examined care before, during, and after surgery, as well as after discharge. The team also evaluated standards of care and CARE Pathways. Changes in protocols were made to prevent the predictable complications of cardiac surgery. A decrease in intubation time, respiratory infections, wound infections, laboratory procedures, length of stay, and costs has been demonstrated. In a follow-up patient and family survey, high satisfaction with nursing care, patient and family education, and length of hospitalization has been voiced. Anticipated goals have been exceeded and improvements in standards continue to be made.
