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  1. Guertin, Lisa MS, RN, ACNP-BC
  2. Earle, Melinda DNP, RN, NEA-BC, FACHE
  3. Dardas, Todd MD
  4. Brown, Christopher PhD


Background: Prolonged length of stay (LOS) has undesirable consequences including increased cost, resource consumption, morbidity, and disruptions in hospital flow.


Local Problem: A high-volume heart transplant center in the Pacific Northwest had a mean index hospital LOS of 23 days, with a goal of 10 days according to the institutional heart transplant care pathway.


Methods: A retrospective, regression analysis was used to identify the factors contributing to LOS of 41 post-heart transplant patients.


Interventions: The post-heart transplant care pathway and order set were modified accordingly and reintroduced to the health care team.


Results: Factors contributing to LOS included number of days (1) until the first therapeutic calcineurin inhibitor level, (2) until intravenous diuretics were no longer required, and (3) outside of a therapeutic calcineurin inhibitor range. The interventions reduced the mean LOS by 8 days.


Conclusions: Increased awareness of LOS, education, and consistent use of care pathways can significantly reduce length of stay.