cardiovascular and thoracic surgery restorative...
TRANSCRIPT
Cardiovascular and Thoracic
Surgery Restorative Technician
Project
Team Members:
Rehabilitation Services Department
Department of Operational Excellence
5 Tower Staff
August 28, 2013
Background
Problem
Patients undergoing cardiovascular and thoracic
surgery procedures at Loyola were experiencing
longer than expected lengths of stay, decreased
patient satisfaction regarding therapy services on 5
Tower and decreased physician satisfaction
pertaining to level of patient activity during the post
operative period
Project Aim
Implement a restorative technician project to increase
patient activity during their hospitalization
Background
Project Goals
Create a restorative technician program for the CV
and thoracic surgery service line to:
Increase number of times patients ambulated during
hospitalization
Improve AVATAR top box percentile for 5 Tower
Decrease length of stay for identified patient population
Perform training and direct supervision of restorative
technician to comply with Illinois Physical Therapy Act
guidelines
Patient Population
Valve 29%
CABG 26%
CABG+Valve 18%
T/AAA 10%
Thoracic 9%
Other 8%
Type of Surgery
Valve
CABG
CABG+Valve
T/AAA
Thoracic
Other
Baseline Data Collection
115 patients undergoing CV and thoracic
surgeries were identified for a 2 month span
Average length of stay was 10.4 days
On average, patients ambulated 4 times daily
between RN/PCT staff, cardiac rehab RNs and
PT/OT
76% of patients were discharged to home
following their hospitalization
AVATAR Top Box Score of 66.67% for therapy
services on 5 Tower
Solution Implemented
On-site training of a restorative technician to
perform daily ambulation with patients
undergoing specified cardiovascular and
thoracic surgeries
7 day a week presence of restorative technician
Provide evening hours of coverage for
optimization of patient activity
Post Data Collection
121 patients undergoing CV and thoracic
surgeries were identified for a 2 month span
Average length of stay was 9.4 days
On average, patients ambulated 6.6 times daily
between RN/PCT staff, cardiac rehab RNs and
PT/OT
77% of patients were discharged to home
following their hospitalization
AVATAR Top Box Score of 73.33% for therapy
services on 5 Tower
Data Analysis
484236302418126
0.20
0.15
0.10
0.05
0.00
LENGTH OF STAY
De
nsit
y
1.359 0.4531 3.724 56
1.651 0.3908 2.540 63
1.913 0.3362 2.093 60
1.238 0.5454 4.861 55
Loc Scale Thresh N
February
March
November
December
Month2
Histogram of LENGTH OF STAY3-Parameter Loglogistic
Data Analysis
363024181260
20
15
10
5
0
363024181260
20
15
10
5
0
February
LENGTH OF STAY
Fre
qu
en
cy
March
November December
Mean 9.161
StDev 5.001
N 56
February
Mean 9.508
StDev 6.048
N 63
March
Mean 10.45
StDev 6.171
N 60
November
Mean 10.42
StDev 6.428
N 55
December
Histogram (with Normal Curve) of LENGTH OF STAY by Month2
Panel variable: Month2
Data Analysis
484236302418126
0.20
0.15
0.10
0.05
0.00
LENGTH OF STAY
De
nsit
y
1.359 0.4531 3.724 56
1.651 0.3908 2.540 63
1.913 0.3362 2.093 60
1.238 0.5454 4.861 55
Loc Scale Thresh N
February
March
November
December
Month2
Histogram of LENGTH OF STAY3-Parameter Loglogistic
Data Analysis
DecemberNovemberMarchFebruary
40
30
20
10
0
Month2
LEN
GTH
OF
STA
Y
Individual Value Plot of LENGTH OF STAY vs Month2
Data Analysis
Patient’s enrolled in the restorative technician
project:
Experienced a decrease in length of stay by one day
Increased the amount of times ambulated daily by 2.4
walks
Increased AVATAR top box scores by 7%
Next Steps
Utilize and adapt restorative technician model
for the General Medicine and General Surgery
service lines in order to increase physician
satisfaction, decrease length of stay, increase
AVATAR scores and prevent patients from
becoming deconditioned during their
hospitalization resulting in discharge to a rehab
facility
Contact Information
Name: Matthew Eggert
Title: Physical Therapy Resource Clinician
Department: Rehabilitation Services
Telephone Number: x61301
Email: [email protected]
Manager: Ewa Jaraczewska
