Abstract Rationale Post-Operative Pulmonary Complications (PPCs) developing after cardiovascular surgery are common and incur an average additional cost of 77, 000 per patient in our facility. Our primary goal with this change of practice was to improve our cardiovascular surgery program outcomes through the treatment of atelectasis. We hypothesized that implementing a standardized positive airway pressure therapy protocol within a multidisciplinary framework would reduce PPCs and associated healthcare costs. Methods A three-month pilot quality improvement initiative was implemented from March-June 2025 involving approximately 300 cardiovascular surgery patients. The multidisciplinary protocol included: VersaPAP therapy initiated within four hours post-extubation and continued QID for ten minutes until ICU discharge or mobilization with physical therapy, and Aerobika oscillatory therapy combined with VersaPAP via RCAT for patients requiring enhanced airway clearance. Implementation barriers addressed included workflow redesign, staff education, EPIC order set development, and assignment prioritization systems. Results Within the first 30 days of the pilot, only 41% of patients received VersaPAP within four hours of extubation. Documented barriers to initiate PAP therapy included respiratory support demands with non-invasive ventilation, neurological instability, hemodynamic compromise, and patient refusal. Focus was placed on reducing patient refusal of PAP therapy through patient education and encouragement through the PAP treatments. At the end of the trial, near elimination of patient refusals led to over 50% of PAP therapy being delivered within 4 hours of extubation. Workflow challenges improved over the course of the pilot with frequent drop-in education sessions with RT staff, monitoring of workflow, and sharing of positive feedback. Serial chest radiographs demonstrated consistent atelectasis resolution within 24-48 hours in compliant patients. Preliminary first quarter data trends suggested reduced PPCs, though definitive outcomes await November 2025 reporting. Conclusions Multidisciplinary VersaPAP implementation shows promise for reducing post-operative pulmonary complications in cardiovascular surgery patients. Success required comprehensive staff education, workflow integration, and consistent therapy delivery. Early radiographic evidence supports therapeutic efficacy when combined with respiratory therapist coaching. This initiative may provide a cost-effective strategy for improving cardiovascular surgery outcomes and regaining quality metrics recognition. This abstract is funded by: None
M Olson (Fri,) studied this question.
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