[HSF] Fast tracking

Sun Aug 26 12:50:05 EDT 2007

"One can not accomplish what one does not believe as any noice in religion
would recognize. Anyone with a vision must be prepared to lead others into
belief. That is what I mean by push. One pushes oneself, or those who would
seek to follow, not those that don't seek."

TRUE ...... IMHO ...... can be applied to any "system" of existence ....

NFA

On 8/24/07, Tea Acuff <tacuff at swbell.net> wrote:
>
> One can not accomplish what one does not believe as any noice in religion
> would recognize. Anyone with a vision must be prepared to lead others into
> belief. That is what I mean by push. One pushes oneself, or those who would
> seek to follow, not those that don't seek.
> tea
>
>
>
>
> ----- Original Message ----
> From: Michael Firstenberg <msfirst at gmail.com>
> To: OpenHeart-L at lists.hsforum.com
> Sent: Wednesday, August 22, 2007 12:39:16 AM
> Subject: Re: [HSF] Fast tracking
>
>
> I am amazed that you can get fast tracking to work.  I was a junior
> general
> surgery resident working on CT when this first came into fashion (and the
> Attending I worked with even wrote papers about it) and I always got the
> sense that patients were getting pushed out of the hospital - at least
> that
> is how they felt.  My understanding was at the time there was a 25%
> re-admit
> rate within the first month - and who knows how many were seen and managed
> with multiple out-patient visits by the Surgeons and their Cardiologists.
> We have been talking about it again recently and it seems that for a
> variety
> of reasons our patient population nevers seems to be ready within a couple
> of days - no matter how good things look.  There are always medical,
> social,
> financial, mental reasons - there is always a reason why they want (need?)
> to stay one more day.  And in this environment no one wants patients or
> families to feel like they are getting kicked out (our customer service
> responses are becoming more important than clinical management issues, but
> that is another story)
>
>
> -michael
>
>
> On 8/21/07, Tea Acuff <tacuff at swbell.net> wrote:
> >
> > I agree that you have room to push, Prasanna. I got back my average 2006
> > LOS for all CAB which was 4.4 days. Aim for 4 get 5-6+. Greater than 85%
> > straight to home (which might be different for you, too?).
> > tea
> >
> >
> > ----- Original Message ----
> > From: Jorge Rodriguez Campos <jrodriguezcampos at yahoo.com>
> > To: OpenHeart-L at lists.hsforum.com
> > Sent: Tuesday, August 21, 2007 3:06:38 PM
> > Subject: Re: [HSF] Fast tracking
> >
> >
> > Dear Prasanna:
> >                     We discharged CABG off-pumb  on day 2-3 and had a 7
> %
> > readmission for thoracic paint or pleural effusions.
> >                     Cases like ASD and MV repairs on day 3-4, and valves
> > same you, of course always uncomplicated surgery.-
> >                       Best regards.             Jorge Rodriguez Campos
> >
> >
> > ----- Mensaje original ----
> > De: Prasanna Simha <prasannasimha at gmail.com>
> > Para: "OpenHeart-L at lists.hsforum.com" <OpenHeart-L at lists.hsforum.com>
> > Enviado: sábado, 18 de agosto, 2007 14:44:06
> > Asunto: [HSF] Fast tracking
> >
> >
> > How fast do the members fast track the patients ie discharge to home
> > (not a Skilled nursing facility etc) a routine uncomplicated case - for
> > eg post op day3 or 5 or 7 or 10 ? especially those who have come from
> > afar.
> > This should obviously exclude the virtually home OPD which I read in an
> > article where they discharged ASD's next day morning but ended up
> > running a virtual ward in the OPD and had a 30 % readmission for
> > effusions etc. We discharge cases like ASD's and MV repairs on Day 4-5.
> > Uncomplicated CABG's on day 5 and valves depending on their stabiltity
> > of INR and the distance from which they come (further they are - the
> > later they get discharged probably between 7- 10 days) earlier if they
> > live close to or in the city so that they can get back for a PT
> > adjustment.
> > How many of you use the self monitored PT systems and also how many of
> > you have used the patients detected phonocardiogram devices to detect
> > early changes in the prosthetic valve acoustic properties ?
> > Prasanna
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