Document Type

Article

Publication details

Postprint of: Chen, Y 2017, 'Implementing same day discharge following percutaneous coronary intervention: a process evaluation', Heart, Lung and Circulation, vol. 26, no. 2, pp. S211.

Abstract available from

https://doi.org/10.1016/j.hlc.2017.06.383

Peer Reviewed

Peer-Reviewed

Abstract

Background: The safety and efficacy of same day discharge following percutaneous coronary intervention is well demonstrated yet there is not widespread implementation of this model of care. Less is known about strategies to effectively implement same day discharge into clinical practice.

Objectives: To undertake a process evaluation to demonstrate the feasibility and acceptability of same day discharge implementation.

Methods: The evaluation setting was a tertiary health service in southeast Queensland. Recruitment, guideline adherence, patient and relative/friend satisfaction were assessed alongside what influenced implementation. Data were collected by taking field notes, and conducting onsite observation, chart audit, satisfaction surveys and interviews.

Results: In the six months following same day discharge implementation, 22 patients were discharged home the same day. Patients expressed high satisfaction for the experience, which was similar to the experience of the relatives/friends. Those patients were all seen by a cardiac rehabilitation nurse and a pharmacist before discharge, but same day discharge checklist and discharge instruction were not done satisfactorily. Besides, only 14 patients out of 22 received next day phone follow-up. The implementation was supported by a researcher's involvement, having a champion and positive perceptions of staff, patients and relatives/friends. Barriers identified included communication issues, staff maintaining established practice, insufficient staff training and role confusion.

Conclusion: Same day discharge following percutaneous coronary intervention is feasible and acceptable. However, strategies are required to be put in place to increase the guideline adherence and address those identified barriers to facilitate a thorough implementation.

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