Exploring outcomes of a nurse practitioner-managed cardiac surgery follow-up intervention: a randomized trial

Aims. To describe and compare the outcomes of a nurse practitioner-managed cardiac surgery follow-up model of care with the standard model of primary care provider follow-up for coronary artery bypass graft surgery patients. Background. Advances in healthcare have had a favourable impact on length of stay following cardiac surgery; however, the shorter length of stay has not been accompanied by enhanced support to bridge the gap between acute care and the community setting. Design. Prospective (2009-2010) randomized study. Methods. Elective cardiac surgery patients (N=200) were randomly assigned to the nurse practitioner follow-up intervention or to the standard model of follow-up care. The main outcomes were health-related quality of life, patient satisfaction, symptoms, and health resource use. Outcome data were elicited via telephone interviews at 2 and 6weeks postdischarge. Results. Baseline differences between the two groups were non-significant; however, at 2weeks postdischarge, the intervention group reported significantly fewer symptoms and higher physical functioning status. At 2 and 6weeks postdischarge, the intervention group was significantly more satisfied with the amount of help, as well as the quality of the services received. Differences in healthcare resource use were not statistically significant. Conclusion. This evidence suggests that the nurse practitioner-managed model of follow-up care effectively bridges the gap between institutional and primary care in the cardiac surgery population.