Assistant Nurse Manager Sugarland, Texas, United States
Disclosure(s):
Naurin Kajani, BSN, RN, CVRN-BC: No financial relationships to disclose
Background: A standardized, charge-nurse-led 48-hour LVAD discharge huddle was initiated to improve interdisciplinary communication, identify potential barriers early, ensure patient and caregiver readiness, and reduce unnecessary delays. This structured process addresses historically fragmented communication and supports safer and more efficient, timely discharge for complex LVAD patients.
Methods: This descriptive quality improvement project evaluated adults with implanted LVADs over a 2-year period. When an anticipated discharge was identified during multidisciplinary rounds, the charge nurse initiated the structured 48-hour discharge huddle. Using a standardized checklist, the team reviewed mobility, ADLs, safety, driveline care, nutrition, medications, equipment, follow-up needs, home readiness, and caregiver preparedness. Data were collected from huddle notes, identified barriers, and discharge timelines, with analysis comparing intended versus actual discharge times and reviewing delay patterns to identify trends and opportunities for improvement.
Outcome: Out of 84 LVAD patients implanted over a 2-year period, 40 were included in the analysis. A review of huddle and discharge dates showed that 85% of discharges met the intended 48-hour timeframe. Common delays included medical necessity, pending prior authorizations for certain medications, pharmacy meds-to-bed delivery, and/or therapeutic blood work. They identified opportunities for more consistent documentation and better coordination among multidisciplinary teams. Based on these optimal outcomes, the team expanded the discharge huddle for established LVAD patients transitioning to rehab or skilled nursing facilities, so that receiving facilities were prepared for LVAD management.
Conclusion: The finding shows that charge-nurse–led LVAD huddles strengthen multidisciplinary collaboration, address discharge barriers, and enhance patient safety and education. It highlights the vital role of nursing leadership in coordinating complex care and supporting smooth, timely transitions home.
