Key result
Rapid cycle improvement shortens cardiac surgery length of stay ~30% and increases early extubation.
Why the study?
Does rapid cycle improvement reduce length of stay and improve outcomes in adult cardiac surgery patients?
Does rapid cycle improvement reduce length of stay and improve outcomes in adult cardiac surgery patients?
Rapid cycle improvement in a community cardiac surgery program significantly reduced length of stay and costs while increasing early extubation rates without adverse clinical impacts.
May support QI initiatives to shorten cardiac surgery LOS; hypothesis-generating pending randomized multicenter confirmation.
This article describes the use of rapid cycle improvement in a community hospital adult cardiac surgery program. The hospital participated in the Breakthrough Series: collaborative adult cardiac surgery sponsored by the Institute of Healthcare Improvement (IHI). As a result of this 1-year project, median length of stay for diagnosis-related groups 104 throug 108 was decreased 30 percent from 8.62 days to 6.0 days; percentage of patients extubated within 6 hours postoperatively rose from 5 percent to 75 percent; median cost per case declined $19 percent; and pain and anxiety, service, and satisfaction scores all improved. There was no adverse impact on the clinical indicators 30-day readmission rate, reintubation, return to operating room, and mortality.
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Doran et al. (1998) studied Adult cardiac surgery. Rapid cycle improvement vs. Pre-intervention baseline was evaluated on Median length of stay for diagnosis-related groups 104 through 108 (days). A 1-year rapid cycle improvement project in adult cardiac surgery decreased median length of stay from 8.62 to 6.0 days and increased early extubation from 5% to 75%.
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