A patient’s postoperative length of stay is dependent on many factors — treatment complexity, resources, patient characteristics and more.
Now, Melinda Phillips, APRN, and team are turning towards multimedia education mediums to help cardiovascular surgery patients feel confident in their postoperative recovery — and go home sooner.
Part of the current issue, Phillips said, is the wide range of patients who come in, anywhere from 20-year-olds to 80-year-olds. Each of them has different levels of independence upon discharge.
“I think they often need one concrete means of information on what is going to happen and what to expect,” Phillips said. “So that maybe they can be better prepared.”
A common barrier to faster discharge are patients who live alone, but will require care after their surgery, Phillips explained.
“Sometimes it’ll be two days before discharge and we’ll learn that they don’t have anyone at home,” Phillips said. “Or they live on the second story. Now, planning for essential postoperative elements like rehab, not to mention standard recovery, becomes a little more complicated.”
Using a patient education video, Phillips and her team are hoping to alleviate some of the discharge confusion by providing patients with a means to arrive well prepared. The script is almost word-for-word the same verbal introduction she gives all of the patients, Phillips said. Only now, they can listen to it as many times as they need to — and even share with family members.
“It mimics our conversations when we first meet during pre-op,” Phillips said. “We tell them where to check in, where we will take them, and run through what every day in the hospital is going to be like, including some postoperative expectations and routines.”
She and her team made one addendum — all of the extra issues they see that delay or complicate discharge. This includes anything from the aforementioned, prevalent stair problem (“Some of our patients have stairs to even get into their home!”) or pets whose care may require a degree of physicality not recommended in the aftermath of a surgery (“If you have a large dog, we ask that you find someone else to walk it while you recover so you do not injure your sternum.”). Each addendum or piece of information in the patient education video comes from real-life experiences Phillips and her team have either dealt with or counseled a patient through.
“We did actually have a patient whose large dog jolted her [on a walk],” Phillips recalled. “Her sternal wires broke and we ended up having to take her back to the operating room.”
When a patient receives his or her surgical date, the surgery coordinators email the video’s link to the patients. This provides them with ample time to prepare and foresee problems, leaving the pre-op appointment as an opportunity to address problems before they happen.
And, for those who have trouble accessing their email, Phillips provides them with a QR code in clinic.
“I’m hopeful that this foray into patient education videos will result in better patient satisfaction and less readmissions,” Phillips said.
“These videos are a wonderful addition to our care pathway,” said Thomas Beaver, M.D., chief of the division of cardiovascular surgery. “We have already heard back from patients that found them very helpful, and I’m grateful to our staff who made them happen.”