Catholic Health East : Best Practices
Catholic Health East
Best Practice Narrative

RHC: Our Lady of Lourdes Medical Center

Category:
New Delivery Models

Contact: Jan R. Weber, M.D.
Telephone: (609)365-7783

Description of the Best Practice
Our Lady of Lourdes Medical Center is a major provider of cardiac services to southern New Jersey. In 1997, nearly 1,300 open heart surgery procedures were performed by a team consisting of 15 cardiothoracic surgeons and supported by over 80 board certified cardiologists.

Members of the cardiac team participated in the Institute for Healthcare Improvement Cardiac Surgery Collaborative and utilized the Plan-Do-Study-Act Rapid Cycle Improvement Concept to reduce the amount of time that a patient remained intubated following open heart surgery. Usual practice at this institution resulted in patients remaining intubated for approximately 12 hours post-op. Because of complications and discomfort associated with intubation, an attempt was made to achieve extubation of at least 80% of our patients within six hours of arrival in the intensive care unit following open heart surgery.

Implementation
A Task Force consisting of representatives from the nursing staff, cardiothoracic surgery, anesthesiology, cardiology, pulmonology, respiratory therapy, and hospital administration was assembled to address the objectives. The overall task was immediately divided into sections, including the development of a modified anesthesia protocol that would reduce the amount of anesthetic agents used during the operation, a modification of the CVU protocol for monitoring respiratory status and for performing extubation, and the establishment of pre-printed orders and changes in intensive care unit policies that would be required to streamline and facilitate the changes in patient care. Also a part of this process was the development of a mechanism for tracking results on a concurrent basis.

Time Frame
The members of the team met for the first time on 10/31/96. Within one week, a re-written anesthesia protocol, draft versions of the new unit policies, and a draft version of the pre-printed orders were available for review and modification. It was agreed that a small group of anesthesiologists and a selected group of surgeons would pilot the project, focusing on low risk first-time routine coronary bypass surgery patients to insure that patient's safety would not be jeopardized and to demonstrate early success in the process. Meetings of the team were held on a weekly basis thereafter for the next two months. During that time, progressive increases in the number of anesthesiologists and surgeons, and increasing levels of patient's severity were incorporated into the protocol. By January, 1997 all members of the CT surgery staff, all anesthesiologists, and all patients were participating in the rapid extubation protocol. Nursing familiarity with the process increased during that time and the results of the project were posted in a conspicuous location in the intensive care unit.

Financial Profile
Establishing the costs associated with a patient being on a ventilator, the cost of monitoring such patients, and the costs of caring for complications arising from the patient being ventilated for an extended period of time were considered to be inordinately difficult. As the primary objective was to improve patient comfort and to emulate models that had been demonstrated to be cost effective in other institutions, it was felt unnecessary as a part of this project to specifically define the financial gains associated with rapid extubation. It is clear however, that there was a significant reduction in the number of laboratory tests performed on these patients as a result of their early extubation. Most conspicuous was the reduction in the use of blood gases. In addition, a reduction in the average amount of time that a patient remained in the intensive care unit was noted. Our tracking system did not allow us to identify specific gains associated with reduction in pulmonary complications, however. Patient satisfaction was assessed by use of a survey. Patients felt no significant change in discomfort as a result of rapid extubation and in many cases strongly applauded the opportunity to be extubated at an earlier time than usual.

Outcome
Average time of intubation was reduced from 13 hours (1995) to 4.56 hours (11/96-2/97). 78% of all patients were extubated within six hours of arrival in the intensive care unit. Length of stay in the intensive care unit for uncomplicated cases dropped by 6.5% for coronary bypass patients and by 19% for patients undergoing uncomplicated valve surgery. Subsequently, three additional surveillance studies demonstrated that this gain had been maintained, with 78% of patients being extubated within six hours on the most recent of these surveillance evaluations.

Best Practice Narrative is limited to a one page summary.
Supporting data is limited to one page.