New Expert Consensus Decision Pathway Provides Checklist For Same-Day Discharge After PCI

A new ACC Expert Consensus Decision Pathway aims to address the uncertainty around same-day discharge after PCI and provides a checklist of clinical, social and facility/systems factors that clinicians can use to help determine whether a patient can be safely considered for same-day discharge.

The Pathway, published Jan. 7 in the Journal of the American College of Cardiology, provides an overview of the evolution of PCI and resulting improvements in safety and efficacy that make it possible for same-day discharge to occur with select adult patients without observed increases in other complications, mortality and readmissions. It also highlights the benefits of same-day discharge after PCI in leading to efficient resource utilization, including increased inpatient bed availability and reduced costs related to supplies and room and board.

The Pathway also outlines pre- and post-PCI considerations for successful same-day discharge, as well as pre-discharge processes, including confirmation of the patient's receipt of a P2Y12 inhibitor prescription, instructions on how to monitor the access site, and confirmation that the patient has appropriate outpatient follow-up scheduled.

According to the writing committee led by Chair Sunil V. Rao, MD, FACC, and Vice Chair Mladen I. Vidovich, MD, FACC, "the ideal time to begin the checklist is before the procedure, but depending on the workflow and resources of individual institutions, the checklist may also be started and completed after the procedure."

Rao, Vidovich, et al., note that the checklist is developed in a way that it can be adapted to fit the needs and processes of individual institutions. They stress that the instructions should "be adapted to conform with the protocols of individual institutions" and note that success of a same-day discharge program will be dependent on a team approach that involves shared decision-making with the patient.

Clinical Topics: Invasive Cardiovascular Angiography and Intervention, Stable Ischemic Heart Disease, Chronic Angina

Keywords: Percutaneous Coronary Intervention, Angina, Stable, Checklist, Delivery of Health Care, Integrated, Delivery of Health Care, Organization and Administration, Patient Discharge

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