The Positive Impact of Pre-Operative VAD Education in the Reduction of Hospital Length of Stay

Purpose Interventions that decrease hospital length of stay (LOS) after ventricular assist device (VAD) implant reduce resource utilization and potentially mitigate nosocomial complications. The purpose of our study was to evaluate the impact of preoperative VAD education on post VAD implant hospital LOS. We hypothesized that multiple education sessions before initial VAD implant would decrease postoperative LOS. Methods and Materials A preoperative education plan (PEP) was implemented on 1/1/12 for all patients undergoing implantation of a Heartmate II (HMII) or a HeartWare HVAD. PEP consisted of two mandatory education sessions for the patient and caregivers, with an optional third session while the patient was in the operating room. LOS of patients who received PEP was compared with those of patients who underwent conventional education post VAD implant using Wilcoxon’s two-sided rank sum test and summarized via median and mean+SD values. Results For the entire cohort, LOS was shorter (p=0.006) for PEP (N=16, median=14.5 days, mean=18.9+ 13.7 days) compared to conventional (N=41, median=22, mean=24+ 12.8 days) by a median of 7.5 days. There was a trend in reduction of LOS with HMII PEP but it was not statistically significant (p=0.073). The LOS was shorter for HVAD (p=0.044) PEP (N=3, median=13 days, mean=15+4.4 days) compared to conventional (N=20, median=22.5 days, mean=24+10.6 days) by a median of 9.5 days. [ figure 1 ] Conclusions Although this study was limited by sample size, the results show a promising trend of a decreased hospital LOS post VAD implant with implementation of preoperative education. Further study of the impact of pre implant education on post implant LOS is needed to confirm our results.