title: The universal bed model for patient care improves outcome and lowers cost in cardiac surgery.
abstract: OBJECTIVE
  With the escalating demands to increase the efficiency and decrease the cost, innovations in postoperative cardiac surgical patient care are needed. The universal bed model is an innovative care delivery system that allows patient care to be managed in one setting from postoperation to discharge. We hypothesized that the universal bed model in the context of cardiac surgery would improve outcomes and efficacy.
  
  
  METHODS
  A total of 610 consecutive patients were admitted to the universal bed unit and prospectively entered into the Society of Thoracic Surgeons National Cardiac Database. Intensive care unit level of care was determined by acuity and staffing needs. Telemetry was employed from admission to discharge, and multidisciplinary rounds were conducted twice daily. Postoperative outcomes were recorded during hospital stay, and comparisons were made with the Society of Thoracic Surgeons National Cardiac Database using identical variables over the same period of time.
  
  
  RESULTS
  Decreased ventilation time, intensive care unit and hospital stay, and reduction in the incidence of atrial fibrillation and infectious complications yielded a financial benefit in the universal bed group compared with the traditional model of admission. Stroke rate and in-hospital mortality were the same compared with regional and national centers. Compared with regional centers, there was an average cost savings between $6200 and $9500 per patient depending on the operation. Patient care satisfaction by independent survey was in the 99th percentile.
  
  
  CONCLUSIONS
  The universal bed patient care model allows for expedient and efficacious care as measured by decreased length of intensive care unit and hospital stay, improved postoperative outcomes, patient satisfaction, and cost savings.
authors.affiliation: Cardiothoracic Surgery Research Program, National Institutes of Health Heart Center at Suburban Hospital, Bethesda, MD, USA.
authors.forename: Abbas
authors.initials: A
authors.lastname: Emaminia
authors.forename: Phillip C
authors.initials: PC
authors.lastname: Corcoran
authors.forename: Michael P
authors.initials: MP
authors.lastname: Siegenthaler
authors.forename: Melissa
authors.initials: M
authors.lastname: Means
authors.forename: Sarah
authors.initials: S
authors.lastname: Rasmussen
authors.forename: Linda
authors.initials: L
authors.lastname: Krause
authors.forename: Damien J
authors.initials: DJ
authors.lastname: LaPar
authors.forename: Keith A
authors.initials: KA
authors.lastname: Horvath
mesh_terms: D000368:Aged; D001513:Beds / Q000191:economics*; D006348:Cardiac Surgical Procedures / Q000009:adverse effects / Q000191:economics* / Q000401:mortality; D016507:Cardiology Service, Hospital / Q000191:economics* / Q000458:organization & administration; D003325:Coronary Care Units / Q000191:economics* / Q000458:organization & administration; D017046:Cost Savings; D017598:Efficiency, Organizational; D005260:Female; D017721:Hospital Costs; D017052:Hospital Mortality; D006801:Humans; D007902:Length of Stay / Q000191:economics; D008297:Male; D008396:Maryland; D008875:Middle Aged; D009741:Nursing Staff, Hospital / Q000191:economics; D010043:Outcome and Process Assessment, Health Care / Q000191:economics* / Q000458:organization & administration; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000191:economics / Q000209:etiology; D011787:Quality of Health Care / Q000191:economics* / Q000458:organization & administration; D012121:Respiration, Artificial / Q000191:economics; D013686:Telemetry / Q000191:economics; D013997:Time Factors; D016896:Treatment Outcome