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Quality assurance and improvement activities involve a continuous loop sequence of clinical care (decisions and application), information monitoring (documentation and assessment), and remediation (education and systems mod ifications). Monitoring and treating clinicians should inter act constantly to improve patient health outcomes through direct communications and other modes of information ex change. This column strives to monitor developments in each of these areas. The following articles represent recent commentaries on these processes. [ABSTRACT FROM PUBLISHER]

Background: Early mobilization is known to decrease length of stay and postoperative complications associated with cardiothoracic (CT) surgery while allowing for an assessment of the patient's functional capacity related to discharge disposition. Purpose: An analysis of the Society of Thoracic Surgery data registry from 2013 indicated, when compared with like-sized programs across the nation, there was a 12% longer length of stay for the CT surgery patient at Jersey Shore University Medical Center. The purpose of the project was to attempt to decrease the length of stay for CT surgery patients via implementation of a cardiac rehabilitation phase I program with a strong emphasis on early ambulation. Design/Implementation: A multidisciplinary committee was convened to design a safe process for ambulation for CT surgery patients who were deemed medically stable to participate. Implementation was possible by concurrently developing an exercise science internship to assist the clinical staff with early mobilization. Evaluation/Outcomes: Assessment of length of stay (LOS) data from February 1, 2014, to May 1, 2014, demonstrated a decreased LOS of 1.24 days. Estimated annual cost savings of $355 136.00 are projected based on calculating an average savings of $400.00 per day x 1.24 x 716 cases. The exercise science interns enjoyed a robust experience and interaction with role models that helped shape their future career choices. Statement of Conclusions: Implementation of a cardiac rehabilitation phase 1 program while concurrently developing an exercise science internship demonstrates a significant financial savings for the institution while positively impacting both the CT surgery patient's postoperative course as well as the future course for the student interns. Implications for practice: Institution of an inpatient cardiac rehabilitation phase 1 program leads to improved patient outcomes while demonstrating a solid financial savings via decreased LOS. [ABSTRACT FROM AUTHOR]