Cleveland Clinic's Cardiac Surgery Initiative Reduces Length of Stay

To care for Cardiovascular Surgery patients as they recovered postoperatively, nurse clinicians on Cleveland Clinic's G80 Unit used to spend their shifts running between floors and calling surgeons to coordinate patients' treatment plans. This wasted both time and energy, and as a result, nurses couldn't always give their full attention to patients, some of whom have cases so complex that they've been turned down by other hospitals.

To resolve these issues, Cardiac Surgery recently piloted a new caregiving approach on Unit G80, in which post-operative treatment is coordinated by nurse practitioners. As part of the new approach, Cardiac Surgery reorganized its coverage areas into zones, including G80, where each surgeon's patients are placed together. In less than a year, this approach has improved efficiency in Cardiac Surgery, shortened length of stay and allowed nurses to develop better relationships with their patients.

Nurse practitioners take the lead
One of the issues the G80 team needed to resolve was the inefficiency of patient care. "There were a lot of providers taking care of these patients, and length of stay was above national benchmarks," says Gina Cronin, Administrator, Thoracic and Cardiovascular Surgery.

Prior to the pilot, surgeons and cardiologists managed their patients' postoperative care plans, which were carried out by surgical nurse clinicians, cardiology nurse clinicians, residents and hospitalists. This system worked well until a patient went into atrial fibrillation or another situation arose in which a decision regarding the patient's care needed to be made quickly.

"The challenge for us was, 'Who do we call for what?'" says Nurse Manager Jackie Spence, RN. "There were a lot more hands in the pot." Often, the patient's surgeon would be called from the operating room for guidance.