Reducing the Duration of Mechanical Ventilation in Postoperative Cardiac Surgery Patients Using a Team Based Approach

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Publication Date

4-9-2015

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Advisor:

J Pelegano Jefferson School of Population Health, Thomas Jefferson University

Abstract

The purpose of this quality improvement project was to decrease the duration of mechanical ventilation for patients undergoing coronary artery bypass grafting (CABG) in a large academic university setting. Our team utilized the PDSA methodology to implement crew resource management tools and visual reminders in an effort to meet best practice standards for this population of patients. We designed a unique tool to monitor and track our progress on a prospective basis. This tool allowed us to identify barriers and common causes for delays in meeting our target for the project. The results of the project showed an increase of patients being removed from mechanical ventilation within six hours postoperatively from 42% to 45%. The percentage of patients removed from the ventilator between six and eight hours decreased from 25% in the pre-project phase to 7.5% after our improvement project. The quality improvement project did not meet our target goal of 60% of patients being removed from the ventilator within six hours of cardiac surgery. However we have demonstrated that daily quality rounds, post-operative huddles, and constant visual reminders can increase communication and team cooperation in an effort to reduce the duration of ventilation in the CABG population. Finally, the project has provided an opportunity to leverage the data from our tracking tool and expand the scope of the effort across the entire episode of care for CABG patients.

Presentation: 30 minutes

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