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Implementing a High-Value Care Discharge Protocol in Patients Undergoing CABG Reduces Readmission
Neel P Chudgar1, Roger Zhu2, Katherine D Gray1
1Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York, New York.
The Annals of Thoracic Surgery
|August 17, 2021
Summary
A new discharge protocol significantly reduced readmissions and length of stay (LOS) for coronary artery bypass grafting (CABG) patients. This high-value care approach improved patient outcomes and discharge destinations without additional resources.
Area of Science:
- Cardiovascular Surgery
- Healthcare Management
- Patient Outcomes
Background:
- Readmission after coronary artery bypass grafting (CABG) is linked to adverse outcomes and increased healthcare costs.
- Evaluating the impact of novel discharge protocols is crucial for improving patient care and resource utilization.
Purpose of the Study:
- To assess the effectiveness of a high-value care discharge protocol on reducing readmission rates.
- To determine the protocol's impact on length of stay (LOS) and discharge destination in isolated CABG patients.
Main Methods:
- A patient-centered discharge protocol was implemented in 2016, focusing on health literacy and follow-up.
- Retrospective analysis of 910 isolated CABG patients (2012-2019) comparing pre- and post-protocol implementation.
- Propensity matching was used to control for confounding variables and validate findings.
Main Results:
- The post-protocol group showed a significant reduction in 30-day readmission rates (6.8% vs 14.4%, P < .001).
- Median postoperative LOS decreased from 6 days to 5 days (P < .001) post-implementation.
- A higher proportion of patients were discharged home post-protocol (82.7% vs 73.9%, P = .002).
Conclusions:
- The implemented discharge protocol significantly reduced readmissions and LOS in isolated CABG patients.
- The protocol facilitated higher rates of discharge to home, indicating improved patient recovery and support.
- This high-value care strategy proved sustainable and cost-effective, enhancing patient outcomes without requiring additional resources.
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