May 22,1996
Media Contact: Sarah Goodwin, 404/727-3366 „ Kathi Ovnic, 404/727-9371 ÜÜ

Patients under 65 whose open heart surgery goes smoothly and who have no other chronic illnesses may often leave the hospital within four or even three days after surgery, reports Emory Heart Center cardiothoracic surgeon Joseph M. Craver, M.D., at a recent meeting of the American Association for Thoracic Surgery. During 1995, Dr. Craver reports that more than one half of all 1,050 open heart surgery patients treated at Emory University Hospital were discharged within five days after surgery. Ninety- eight heart patients were discharged within three days, 252 were discharged after four days and 205 were discharged after five days. In the past, patients usually have stayed in the hospital six to eight days after open heart procedures such as coronary artery bypass surgery. "Though not appropriate for every patient, the measures which enable patients to be discharged early after heart surgery are desirable for most patients," Dr. Craver says. "Not only does early discharge reduce patients' hospital costs, but the techniques can enhance and accelerate recovery and rehabilitation to full activities." Staff at Emory University Hospital work together to keep patients on "critical pathways" which streamline yet maximize patient care. "Critical pathway design for open heart surgery patients must involve participation by staff in Surgery, Anesthesiology, Nursing/Operating Room, Cardiology, Hospital Administration, Pharmacy, Nutrition/Dietary Services, Social Services, Radiology and Laboratory Services," Dr. Craver says. He points out the following important junctures along the critical pathway: 1. The preadmission evaluation, and education of the patient and family regarding what to expect. 2. Efficient conduct of anesthesia and surgery to reduce the potential for complications and delays. 3. Early awakening and ambulation (movement) of the patient. 4. The patient's progressive mobilization and return to independence. 5. Careful early social planning for discharge, a key component of which is family support. 6. Conscientious aftercare, including personal follow-up contact with the patient made by staff of the surgical center and the surgeon. "Early discharge pathways succeed by the gentle encouragement of the entire staff regarding the patient's accelerated course because it is possible and desirable -- not merely because of pressure to reduce costs and length of hospital stay," Dr. Craver says.

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