Implementation Strategies for Same Day Discharge Post Percutaneous Coronary Intervention: An Integrative Review

Chen, Yingyan; Marshall, Andrea P.; Lin, Frances

doi:10.1111/wvn.12163

Cited by 5 publications

(4 citation statements)

References 51 publications

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“…Implementation of an SDD program has been estimated to save hospitals $3000–$6000 per case, resulting in savings of $108,000 to $216,000 per every 100 elective PCIs for hospitals operating in the 75th percentile of SDD 41 . An integrative review by Chen et al 22 found that guidelines, environment, education, audit, or feedback were important strategies for the success of SDD programs.…”

Section: Discussionmentioning

confidence: 99%

“…13,15 The 2009 consensus document from the Society for Cardiovascular Angiography and Interventions (SCAI) released criteria for SDD, 16 which we followed in the development of our SDD program. Over time, several randomized and observational studies demonstrated the safety of SDD in high-risk patient subgroups, 15,[17][18][19][20][21][22][23][24][25] which led to a change in the recommendations and definition of high-risk PCI. 26 New guidelines have also been developed to determine which patients are considered safe for SDD.…”

Section: Introductionmentioning

confidence: 99%

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Outcomes of same‐day discharge following percutaneous coronary intervention in a rural population

Ginete

Groth

Rudeck

et al. 2023

Cathet Cardio Intervent

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BackgroundSame‐day discharge (SDD) following percutaneous coronary intervention (PCI) is safe, yet the nationwide rate of SDD remains low. The impact that residing in a rural area has on the safety of SDD is unknown.ObjectiveTo investigate the safety of SDD compared to next‐day discharge (NDD) among PCI patients living in a largely rural area.MethodsThere were 3502 outpatient elective PCIs at a tertiary care center between January 1, 2011 and December 31, 2017. Data from the National Cardiovascular Data Registry CathPCI Registry® and the electronic medical records were obtained for patient demographics, procedural characteristics, and procedural outcomes. Data from the initial PCI in each 365‐day period were included in the analysis for each patient. Rural–Urban Commuting Area codes 4–10 were used to define rural status.ResultsA total of 2099 (59.9%) PCIs met the inclusion criteria (63% rural). The overall rate of SDD increased over time (4.7% in 2011 to 39.6% in 2017) as radial access increased (14.2% in 2011 to 59.9% in 2017). In this population, a total of 329 PCIs had SDD (15.7%; median (interquartile range) age 66.0 (14.0) years, 20.1% female, 52.3% rural status). Compared to NDD, SDD patients had less hyperlipidemia, atrial fibrillation, congestive heart failure, history of coronary artery bypass graft, and more radial access. SDD was noninferior to NDD for 30‐day readmission but had a decreased 1‐year (adjusted odds ratio [aOR]: 0.20, 95% confidence interval [CI]: 0.05–0.81, p = 0.024) and 5‐year (aOR: 0.43, 95% CI: 0.28–0.66, p < 0.001) all‐cause mortality compared to NDD. Rural status did not predict outcomes.ConclusionsSDD in patients in rural areas does not have a significantly higher rate of 30‐day readmission. SDD patients had lower odds of 1‐ and 5‐year mortality when compared to NDD. Future studies prospectively evaluating the safety of SDD in this population are warranted.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Outcomes of same‐day discharge following percutaneous coronary intervention in a rural population

Ginete

Groth

Rudeck

et al. 2023

Cathet Cardio Intervent

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“…10 While the evidence for the safety and effectiveness of SDD is well described in the literature, there is little reported which can be used to help guide the implementation of SDD within complex healthcare systems. 11…”

Section: Introductionmentioning

confidence: 99%

Lessons learnt from the implementation of same-day discharge after percutaneous coronary intervention

Chen

Marshall

Lin

2019

Australian Critical Care

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Background: Change in healthcare organisations is constant and requires adequate resources for effective implementation. Same-day discharge after percutaneous coronary intervention has been found to be no different from the patients who stayed overnight after procedure; however, its uptake remains low. Objectives: The aim of the study was to identify what factors helped or hindered the implementation of same-day discharge. Methods: This interpretive study was conducted in a cardiac catheterisation suite of an Australian tertiary hospital between June and December 2016. Semistructured individual interviews with 26 healthcare professionals were conducted to explore the factors that influenced the implementation. A deductive approach to content analysis was guided by the theoretical domains framework. Findings: Five domains, including beliefs about consequences, professional role and identity, resources, behaviour regulation, and optimism, were identified which were strongly related to the factors that impacted the implementation. The findings showed that participants believed same-day discharge benefits while also concerning about its safety and holding different opinions on eligibility criteria. The findings also showed that participants' involvement in the change process varied with no clear roles and responsibilities and that their understanding about same-day discharge evidence and the guideline also differed. Lack of dedicated resources was also identified as the hindrance to the implementation. Behaviour regulation domain depicted how communication was managed and how the care for same-day discharge patients was improved. Despite several issues identified, participants were optimistic with achievement. Discussion and conclusion: This study has provided valuable insight into the factors that influenced the implementation, which will inform policymakers when designing interventions for future improvement. Plan for change and involvement of all stakeholders along with dedicated resources including time, people, and change management expertise are essential if hospitals want to see the success of change.

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“…Although SDD has been shown to be safe and feasible, [5][6][7] its uptake within health services worldwide has been variable. While there is a growing body of literature describing the impact of SDD on patient and health service outcomes, [5][6][7][8] the process of implementing SDD has not been well described in literature and there is little information available 9 to inform clinicians wanting to implement this model of care. To address this gap in the literature, we undertook this process evaluation study aimed to evaluate the implementation of SDD as a new model of care in the cardiac service of an Australian tertiary teaching hospital.…”

Section: Introductionmentioning

confidence: 99%

Implementing Same Day Discharge Following Percutaneous Coronary Intervention

Chen

Lin

Marshall

2019

Journal of Nursing Care Quality

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Implementation Strategies for Same Day Discharge Post Percutaneous Coronary Intervention: An Integrative Review

Cited by 5 publications

References 51 publications

Outcomes of same‐day discharge following percutaneous coronary intervention in a rural population

Outcomes of same‐day discharge following percutaneous coronary intervention in a rural population

Lessons learnt from the implementation of same-day discharge after percutaneous coronary intervention

Implementing Same Day Discharge Following Percutaneous Coronary Intervention

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