AUTHORS
Editor in Chief
Phalan L. Bolden, MSN, FNP
Peggy McElgunn, Esq.,
Executive Director
Sanger Heart & Vascular Institute
Latasha S. Ruffin, DPT, PT
Carolinas Medical Center
Contributing Editor —
Quality
Mary Heisler,
ACE
REDUCING
LENGTH-OF
-STAY POST
AMPUTATION
According to the CDC, in 2009, the average
length of stay for non-traumatic lower extremity amputations was 9.8 days. The arithmetic average length of stay at Carolinas
Medical Center for non-traumatic below
knee amputation from September 2012- August 2013 was 17.78 days.
The purpose of the Vascular Amputation Task
Force was to develop a pathway that involved members of the multidisciplinary
team for a holistic approach in delivering
consistent, effective and efficient quality of
care to patients post amputation.
To supersede the data released in 2009 and
the CDC statistics for the average length of
stay for lower extremity amputations, the
goal was to decrease the length of stay from
surgery to discharge to three days.
Contributing Editor —
Technology
Ike Miller,
Carolinas Medical Center
focused education on transfers, positioning,
and contracture prevention. Results have
shown that the implementation of PCA preoperatively for pain management has led to
better functional outcomes.
Contributing Editor —
Reimbursement / Finance
The collaboration of care between physical/
occupational therapy, the liaison with volunteer support services, close co-morbidity
monitoring, (i.e. diabetic screening, lipid profiling, pain control), has contributed to the
efficient discharge to appropriate disposition
with the help of case management.
Contributing Editor —
Administrative Matters
The timeliness of feedback with self-audit
results, the use of rapid cycle of Plan-DoStudy–Act Model for Performance Improvement, the tangible support of administration,
the setting of co-leadership, and the leveraging of the practice in this new process were
all innovative ingredients in the success of
this initiative.
Information on Peripheral Arterial Disease
Throughout the pilot process, changes in
regards to timeliness of consultations and
pain control were made based on the needs
of the patients. As a result of this standardization, care for patients post amputation has
become more effective, thus reducing the
timeframe from admittance to discharge to
the appropriate disposition.
The program reduced length of stay from
17.78 days to 9 days for the below knee amputation population and from 7.46 days to
5.66 days in the above knee amputation population. This reduction provides savings of
$2,247.00 per day in room cost alone.
The pathway has provided timely patient
care and improved quality of care through
Peripheral arterial disease (PAD) is a condition characterized by atherosclerotic occlusive disease of the lower extremities. PAD is
a major risk factor for lower-extremity amputation. The disease also suggests a high likelihood for symptomatic cardiovascular and
cerebrovascular disease.
David Strelow,
MidAmerica-St. Luke’s
Jon Gardner,
Centura
Contributing Editor —
Research & Evidence Practice
Linda Paxton,
Chippenham Johnston Willis
Advertising Director
Sean McElgunn,
VP Corporate Relations
Managing Editor
Kurt Jensen,
Communications Director
For more information on PAD compiled by
authors Bolden and Ruffin, visit the Alliance
of Cardiovascular Professionals’ blog at
acp-online.org/blog.
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