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Implementing an open heart surgery (OHS) program presented the opportunity for several community based hospitals to challenge the way they had been providing patient care and establish an innovative approach to post surgery patient care. The One Stop Post Op™ cardiovascular recovery unit was designed to receive the OHS patient directly from the operating room and to be the “care unit” for the patient’s entire stay. Patient flow, quality monitoring and caregiver acceptance in this unit requires new paradigms from the traditional two or three step post OHS care delivery process. The One Stop Post OP™ model focuses the delivery of care on the patient. With proven success in clinical outcomes, and patient, physician and caregiver satisfaction it is anticipated that this new approach will drive hospitals to evaluated how to integrated clinical process with physical plant planning in the future.Features and BenefitsThe One Stop Post Op™ concept of post-operative open-heart surgery care provides patient focused care across the continium, from the pre and immediate post-op period until discharge. The level of patient care changes, the equipment changes, but the patient remains in the same room receiving care from the same nursing staff. While this is not a new concept to health care, it is relatively new to post-operative open heart surgery recovery. In traditional open heart surgery recovery models the patient is transferred from an Intensive Care Unit to an intermediate care unit and possibly to a non-monitored bed prior to discharge. The traditional process moves the patient to the care source instead of applying a patient responsive approach that delivers services directly to the hospital’s customer. The One Stop Post Op™ model reduces care costs by eliminating inefficiencies associated with transfers. Streamlining care delivery affects length of stay as consistent caregivers, familiar with the patients and the medical conditions that can occur following OHS surgery, recognize and immediately address complications. The nurses in “one-stop CVU units” are clinical specialists in pre and postoperative open-heart surgery care, experts in early recognition of clinical complications and can provide rapid intervention, optimizing clinical pathway variance monitoring and management. In addition, One Stop Post OP™ nursing and ancillary staff address patient discharge issues of homecare, family support and skilled facility placement, eliminating a fragmented planning process that can frequently occur when patients are transferred to several post operative care units. Physicians, nurses and ancillary staff have the opportunity to bond as a continuous quality improvement team that can experience the success of discharging patients who have recovered from their OHS surgery. This is “real time” quality feedback. Satisfaction is not limited to patients and families; physician, staff and ancillary personnel appreciate this innovative approach to care. The One Stop Post Op™ model provides an environment that facilitates staff empowerment and ownership with all caregivers focusing on the entire recovery process.Key PointsExcellent satisfaction: Patients, Nurses, PhysiciansThe One Stop Post Op ™ cardiovascular recovery unit has documented results that patient satisfaction can be improved with this innovative care delivery model. Nursing retention was higher and was attributed to increased job satisfaction while working in a unit that implemented this model. Physician survey scores reported excellent grades for patient care and nurse response. Lowered length of stay Crossed trained multifunctional teams review each patient’s clinical progress and care needs daily. The recovery variance monitoring results in improved clinical pathway management. Patient progress is reviewed with aberrations addressed, often resulting in no delay in the patient’s progression. This real time process permits patients to “catch-up” to their expected course of recovery resulting in lowered length of stay and lower cost of care. Operational and staffing cost efficienciesPatients in the One Stop Post Op™ are cared for by nurses with advanced critical assessment skills and cardiovascular recovery care experience who are prepared to identify post-op complications and address care needs earlier. Problems are identified and resolved quickly with all members of the team understanding their role. The One Stop Post Op™ facilitates continuous quality enhancement in one setting. Staffing is flexed to optimize resources and can be adjusted every four hours.Continuous communication Due to the specialized nature of post operative open heart surgery care and the need for a dedicated care team, the care givers share a common goal and have constant opportunity to dialogue. The patient is not moved and the same nurses, physicians, and support staff care for them during their entire stay. Active family communication and involvement is a corner stone of this delivery system, making the patient and their family the focus of all activity. The patient and family receive education from the same staff that is administering the post operative care. They are encouraged to question therapies and treatments and are involved in care decisions through out the patient hospital stay. Active family involvementThe One Stop Post Op™ unit fosters an environment centered on patient and family. Family visiting is open and supported with rooms optimally designed to address this unit’s approach. The family is included in the pre-operative teaching and continues to be an active participant in the educational process through patient discharge. Interactions with familiar nursing staff promote active communication. The families have also found that the surgeons are frequently in the unit and available to discuss the patient’s recovery process and answer their questions.Employee ownership Another unique feature of The One Stop Post Op™ model is that it creates an empowering environment, which fosters ownership. The nursing and ancillary staff assigned to these units tend to refer to the OHS patients as “our patients”. The opportunities for bonding between staff, patients and families are extraordinary. Medical direction provides for a defined understanding of duties and responsibilities so that unit performance expectations are clear and achievable for caregivers.Clinical expertiseThe nursing care provided in The One Stop Post Op™ cardiovascular unit is highly specialized. Nurses who traditionally worked in short term recovery units are caring for patients through out their hospital stay and are encouraged to approach patients from a holistic platform. Caregivers interact with patients and families through the continuum of care and are able to appreciate the success of patient discharge. Nurses with critical care skills provide care at all levels. This expertise provides the opportunity for extraordinary trust between physicians, patients, families and ancillary staff. Complications are recognized quickly by nursing staff and timely response can prevent compromise to the patient’s condition. Distinguish your program from the competition The traditional care delivery method of transferring patients based on acuity is utilized by most facilities nationwide. By implementing the One Stop Post Op™ approach to open heart surgery recovery, hospitals can offer differentiated and distinguish care. Reduced length of stay and exemplary clinical outcomes are the benchmarks of a successful program that will be attractive to the community and payors of healthcare. The satisfaction achieved by patients and stakeholders will clearly set this type of open-heart surgery program apart from the others.