(http://creativecommons. org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.Healthcare systems around the world share the common goals of improving clinical outcomes, optimizing cost reductions and efficiencies, and expanding access to care in a patient-centric manner, yet they are stymied by 2 critical challenges: wide variations in patients' clinical outcomes and soaring costs. In response to these challenges, many healthcare systems throughout the world are pivoting towards value-based healthcare (VBHC), to ultimately 1) move from volume-based to value-based care, 2) promote patient-centric care, and 3) reverse rising costs. While the United States and European nations are piloting alternative payment models, South Korea has a similar set of objectives to adopt value or performance-based payment systems. Two exemplary programs helping to move Korea towards a VBHC model are currently under way: the Support Fund Program for Care Quality Assessment and the Healthcare Benefit Appropriateness Assessment Program. However, in order to permanently establish a full-fledged VBHC system in Korea, the following prerequisites must be met: 1) normalization of provider payment rates, 2) development and dissemination of critical pathways, 3) implementation of pilot projects in the medical device sector that contain risk-share payment schemes, 4) implementation of registries to aid data-driven coverage decisions, and 5) implementation of bundled payment pilot programs for the medical conditions for which proven critical pathways already exist. Ultimately, the medical device industry is in a unique position to enhance ongoing endeavors by Korean health authorities and providers to achieve quality patient care and cost savings, all in the service of the transition to VBHC.
Purpose/Aims
Current practice in Korean medical institutions executes prolonged average length of stay post–cardiac surgery, imposing higher risks of mortality and morbidity, along with administrative issues resulting in long waiting lists for future cardiac surgery. The purpose of this article is to develop and evaluate an early discharge protocol after cardiac surgery led by clinical nurse specialist in a Korean medical institution.
Description of the Project/Program
The project of implementing early discharge protocol seeks to provide an efficient delivery system for patients who are undergoing cardiac surgery. To evaluate the efficacy of this project, a group of cohorts administered with early discharge protocol was compared against the control group for their length of hospital stay, adverse complications, and clinical outcomes such as postoperative mortality and morbidity.
Outcomes
The early discharge protocol group had a decreased hospital length of stay by 30% (P < .05) compared with the control group under the conventional discharge protocol while maintaining patient safety and minimizing exposure of patients to further risks of mortality and morbidity.
Conclusion
Clinical nurse specialist–led early discharge protocol in patients who received cardiac surgery decreases length of stay, thus minimizing exposure of patients to further risks of mortality and morbidity.
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