title: Breakthrough change for adult cardiac surgery in a community-based cardiovascular program.
abstract: 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.
authors.affiliation: Mercy and Unity Hospitals, Minneapolis, MN, USA.
authors.forename: K A
authors.initials: KA
authors.lastname: Doran
authors.forename: S A
authors.initials: SA
authors.lastname: Henry
authors.forename: B J
authors.initials: BJ
authors.lastname: Anderson
mesh_terms: D000328:Adult; D006348:Cardiac Surgical Procedures / Q000592:standards*; D002985:Clinical Protocols; D017046:Cost Savings; D006764:Hospitals, Community / Q000592:standards; D006801:Humans; D007902:Length of Stay; D008910:Minnesota; D009873:Operating Rooms / Q000191:economics; D010149:Postoperative Pain / Q000628:therapy; D010348:Patient Care Team; D017060:Patient Satisfaction; D013503:Surgery Department, Hospital / Q000592:standards*; D017749:Total Quality Management / Q000379:methods*