Reducing Length of Stay in Patients Undergoing Open Heart Surgery: The University of Pittsburgh Experience

The clinical pathway, one component of the case management model, was implemented at one university medical center in the coronary artery bypass surgical group. In this article, the authors describe the development, use, and evaluation of the clinical pathway. The role of the advanced nurse practitioner as the case manager is discussed. The initial data base created by the case manager includes patient demographics, daily progress, length of stay, charges, discharge disposition, and readmissions within 15 days. Data collected on all patients undergoing coronary artery bypass graft surgery from July 94 to October 94 are reported and compared with the benchmark set with the development of the clinical pathway. Strategies developed for future improvement in the clinical pathway process and data management are identified