Reducing Length of Stay after Lung Transplant through Implementation of Multi-Disciplinary Care Coordination Rounds

Purpose Aim of this project was to reduce length of stay (LOS) after lung transplant surgery (LT) by implementing multi-disciplinary care coordination rounds (MDR). Methods We performed a single-center study analyzing efficacy of weekly MDR focused on discharge planning for new LT recipients. Providers involved in MDR included social workers, pharmacists, case managers, physical-, occupational-, and speech-therapists, dietician, nurse coordinators, and nurse practitioners. MDR efficacy was evaluated by comparing a prospective cohort of LT recipients exposed to MDR from January to August 2019, to a retrospective cohort of LT recipients who underwent LT from January to December 2018. Demographic and clinical characteristics: age, sex, days hospitalized prior to LT, mechanical ventilation and/or ECMO support prior to LT were collected from the medical record. Primary outcome was overall length of stay following LT surgery. Secondary outcomes included ICU LOS, Results Forty subjects underwent LT from January to August 2019 comprising the intervention population (Table). Prior to the intervention, 2018 median hospital LOS was 21 days (14,33), median ICU LOS was 6.5 days (5,21), 4 (7%) Conclusion MDR was implemented to facilitate interprofessional collaboration to minimize barriers to discharge after LT surgery. This reduced post-ICU LOS by 29% while maintaining comparable ICU LOS, an expected finding with similar acuity between cohorts. Further analysis of readmission rate is warranted.