[HSF] Fast tracking

[Prasanna Simha]

That is very true. Just now we have a patient in the ward  who just 
doesn't want to go home (day 8) and I told him that all we are doing is 
saying hello to each other and he would be better off eating home 
food.(He has still not gone home as of this AM). I do agree that if we 
tell them we will discharge them on day 3 that they will go home on day 
5. I think part of the blame is on their perceived comparison to say, GI 
surgery with postoperative ileus etc where patients go home much later . 
They find it difficult to comprehend that they are getting what can be 
considered more "complex" surgery and yet are being  sent home earlier. 
Inf fact when I was new cardiac surgery resident I was surprised that 
patients are up and about much faster than general surgery patients with 
major abdominal surgery ( for e.g major resections / Whipple's etc).
Prasanna
Mark Levinson wrote:
>
> On Aug 24, 2007, at 9:43 PM, Tea Acuff wrote:
>
>> I agree with your sentiments. However, this is the number that comes 
>> back from my STS data
>
> Tea:
>
> I watch my bi-annual STS reports, and I have noticed that the average 
> (mean) LOS for CABG has not changed
> in 12 years!     It was 7 days in 1995 and still today....Curious.
>
> I know that many of us are trying hard to get patients out of the 
> hospital early, but the average does not budge (nationwide).
> So, my fealing is that we are succeeding in the younger patients, and 
> this is offset by longer LOS in the increasingly
> older and sicker elderly patients.     For the sake of calculating the 
> mean, these older patients erase the gain we can
> achieve in the younger.
>
> In order to get patients out earlier than day 3, we must educate them 
> prior to surgery that we expect them to go
> home on day 2 or day 1.     Their response to that information will 
> quickly determine if you are going to succeed
> or fail...the patient that wants to go home early often does.       
> More typically, the patient that does *not* want to go
> home early never will!
>
> Mark
>
> Mark M. Levinson, MD
> Founder, Editor-in-Chief,
> The Heart Surgery Forum
> WWW: <http://www.hsforum.com>
> Email: <mmLevinson at hsforum.com>
>
>
>
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