Cardiac surgery
Better care for heart valve surgery
Heart valve disease is usually a major physical and psychological burden for those affected. The INCREASE project aims to improve care with an innovative interdisciplinary approach before, during and after heart valve surgery.
In Germany, more than 30,000 heart valve operations are performed every year - in most cases due to signs of wear and tear. As the population tends to get older, heart valve diseases will also increase and with them the number of minimally invasive procedures. Further development of care is therefore important.
Scientists in the INCREASE research project are building on this and want to improve care management before, during and after the operation (perioperative) through close cooperation between the disciplines involved (including surgery, cardiology, nursing, physiotherapy and psychosomatic medicine). The INCREASE concept is being scientifically tested in a study at the University Medical Center Augsburg at the University Medical Center Hamburg-Eppendorf. The HCHE is involved in the health economic evaluation. The project itself is being funded with around 5.2 million euros by the Innovation Committee of the Federal Joint Committee (G-BA).
Until now, patients who have undergone heart valve surgery have stayed in hospital for an average of ten to twelve days before starting rehabilitation. As a result, they do not regain full mobility until later. In addition, the long stay in hospital often leads to physical weakness and pain. The INCREASE concept provides for patients and their relatives to have an informative discussion with the entire medical team (heart surgeons, nursing staff, physiotherapists, psychosomatic specialists and rehabilitation management) three weeks before the operation. A specific diet and physiotherapy exercises for preventive activation are also prescribed before the operation. A dedicated contact person accompanies patients throughout the entire care phase. After the heart valve operation, patients are woken up in the operating room and then transferred to the monitoring ward instead of the intensive care unit. The first physiotherapy treatment takes place just three hours after the operation. This close-meshed interdisciplinary care is intended to enable patients to mobilize early after the operation and actively involve them in the healing process. As soon as possible, patients should be transferred to a rehabilitation clinic to continue the interdisciplinary healing process.
The INCREASE project team is testing its concept in a study with patients from Hamburg, Schleswig-Holstein, Lower Saxony and Bavaria. Divided into two groups, the participants receive treatment according to the INCREASE concept (intervention group) or are treated according to standard care (control group). The project team first compares the length of the respective hospital stay and the treatment costs. A walking test and standardized questionnaires are also used to determine whether the participants in the intervention group are in a better physical condition when they are discharged from hospital compared to the control group and whether there is evidence of an improved quality of life a few months after the procedure.
The results of these investigations will be fed back to all those involved in treatment and incorporated into a guideline. The newly developed standard of care should be transferable to both urban and rural regions and could be used in all heart centers in Germany following a positive evaluation of the study. The study sites in Hamburg and Augsburg are working together with the BARMER health insurance company, several clinics and health and rehabilitation centers.
Project dates INCREASE
Client: Innovation Committee at the Joint Federal Committee (Innovation Fund for the Promotion of New Forms of Care (Sections 92a (1) and 92b SGB V), DLR Project Management Agency
Duration: 2021-2024
Transfer service:
- Evaluation of the costs of the new form of care compared to standard care from a hospital perspective on the one hand and from a social insurance perspective on the other
- In addition, a cost-effectiveness analysis will be carried out from a societal perspective
Transfer target group:
- Hospitals
- Health insurance companies
- Service providers in the healthcare sector