Reducing Trainee Service Provision Burden: An Audit of Cardiac Surgical Follow-Up

Area of Science:

• Cardiothoracic Surgery
• Healthcare Management
• Surgical Outcomes

Background:

• Outpatient follow-up appointments are crucial after cardiac surgery but can be resource-intensive.
• Standardizing discharge policies can optimize clinic efficiency and trainee workload.

Purpose of the Study:

• To implement and evaluate a standardized discharge policy for cardiac surgery outpatient appointments.
• To reduce the burden on trainee surgeons and improve clinic efficiency.

Main Methods:

• A retrospective audit of current practice was followed by a prospective audit after intervention.
• Data were collected from 1002 patients attending cardiac surgery follow-up appointments over three periods.
• The intervention involved introducing departmentally agreed discharge guidelines.

Main Results:

• Inappropriate patient recalls decreased significantly after guideline implementation (4.6% vs 17.6%).
• This reduction was sustained at one year and was independent of the registrar managing the patient.
• Annual cost savings of £3841 were estimated, with no increase in re-referrals.

Conclusions:

• A standardized discharge guideline effectively reduced unnecessary outpatient attendances in cardiac surgery.
• The guidelines improved trainee experience by increasing new patient assessments.
• The policy change was cost-neutral and did not negatively impact patient safety regarding re-referrals.