If the cardiovascular surgeries include heart bypasses, transplants, etc. it has quite an impact. The surgical area isn't the only one that will need specially trained personnel and new equipment. There MUST be in place a properly trained post care unit, proper staffing of ancillary services such as blood banks, radiology, and respiratory departments as well as proper equipment to monitor these patients after surgeries. Once the patient moves out of the intenstive care unit there must be staff that recognizes post surgical complications. Too often hospitals jump into this without these considerations and end up wasting millions of dollars before finally stopping the program because of high mortality rates. It should be a system-wide change or it won't be successful. Time cannot be wasted when it comes to staff obtaining blood gases, blood, radiology services, lab results, etc. Staff all over the hospital must be trained to recognize problems with these patients and have the backing to act quickly to solve them. Don't discount the fact that surgeons can make or break the program too.