Implementing the Fast Track Improvement Bundle: A Total Joint Replacement Quality Improvement Project
Date of Graduation
Project/Capstone - Global access
Master of Science in Nursing (MSN)
School of Nursing and Health Professions
Michael Bueno, MSN, RN, CNL
The Fast Track program is a patient-centered and evidence-based intervention for post-surgical patients. It is widely used in many hospitals today because it has proven to promote early recovery, reduce postoperative complications, and decrease both length of stay and medical costs. Within a non-profit, Magnet community based hospital, the Fast Track program was implemented in April 2019. Currently, the success rate of the program is at 74%, which has warranted the initiation of a Quality Improvement (QI) project.
This project began with a microsystem assessment, root cause analysis (RCA), and strengths, weaknesses, opportunities, threats (SWOT) analysis. Four main barriers were identified as contributing factors to this program’s lack of success. These barriers were as follows: 1) lack of a uniform location on the checklist to write the patient’s discharge time and/or reasons they went "off-track," 2) lack of patient education on Fast Track criteria, 3) lack of nursing education on the program, 4) lack of preoperative education on patient's Fast Track status.
The recommended intervention is the Fast Track Improvement Bundle. This bundle includes an updated checklist requested by nurses, bedside patient checklist, talking points and in-service to educate nurses, and a Fast Track educational powerpoint slide to be utilized during the preoperative class. The future steps of this project include a formal implementation of the bundle and evaluation of its success. The expected result is >95% success rate of on-time Fast Track discharges.
Cho, Kathleen; Ryu, Grace; Palmer, Laura; Eng, Crystal; and Danneman, Shannon, "Implementing the Fast Track Improvement Bundle: A Total Joint Replacement Quality Improvement Project" (2019). Master's Projects and Capstones. 959.