PMID- 33709146
OWN - NLM
STAT- MEDLINE
DCOM- 20220331
LR  - 20220408
IS  - 1873-1953 (Electronic)
IS  - 1474-5151 (Linking)
VI  - 20
IP  - 7
DP  - 2021 Oct 27
TI  - Implementation of an accelerated discharge process following percutaneous 
      coronary intervention for patients with non-ST elevation acute coronary 
      syndromes.
PG  - 660-666
LID - 10.1093/eurjcn/zvaa029 [doi]
AB  - AIMS: Historically, patients with non-ST elevation acute coronary syndrome 
      (NSTE-ACS) are monitored as inpatients following successful percutaneous coronary 
      intervention (PCI), but accumulating evidence demonstrates that accelerated 
      discharge is safe, reduces cost, and enhances patient satisfaction. This quality 
      improvement project examined the impact of implementing a post-PCI streamlined 
      discharge process for NSTE-ACS patients on length of stay (LOS), major adverse 
      cardiovascular events, and provider utilization at a university-affiliated 
      hospital system. METHODS AND RESULTS: Clinical characteristics, the timing of 
      admission, PCI, and discharge data were collected prospectively from patients 
      presenting to the catheterization laboratory for intervention for NSTE-ACS during 
      90-day historical control and implementation periods. The knowledge to action 
      implementation model was employed to establish a peer-coaching based educational 
      tool for educating interventional cardiologists and inpatient clinicians 
      regarding patients with low-risk characteristics suitable for same-day discharge 
      (SDD) following PCI. Patient characteristics were similar between the historical 
      and implementation periods. Although total hospital LOS did not decrease (51 +/- 24 
      vs. 41 +/- 18 h; P = 0.14), the discharge process reduced LOS after PCI among 
      low-risk patients (22 +/- 6 vs. 17 +/- 8 h; P = 0.003). Complication and readmission 
      rates were unchanged by SDD. Provider utilization of the discharge process 
      increased four-fold during the implementation period (8% vs. 32%; P = 0.02). 
      CONCLUSIONS: Implementation of an accelerated discharge process following PCI for 
      low-risk NSTE-ACS patients reduced post-PCI LOS without increasing readmissions 
      or complications. Increased utilization of the process throughout the 
      implementation period may be attributed to peer coaching.
CI  - Published on behalf of the European Society of Cardiology. All rights reserved. (c) 
      The Author(s) 2021. For permissions, please email: journals.permissions@oup.com.
FAU - Slone, Sarah E
AU  - Slone SE
AD  - University of South Carolina College of Nursing, 1601 Greene St, Columbia, SC 
      29608, USA.
AD  - Johns Hopkins University School of Nursing, 525 N Wolfe St, Baltimore, MD 21205, 
      USA.
AD  - Cardiology, Palmetto Health-USC Medical Group, 8 Medical Park Dr Ste 100, 
      Columbia, SC 29203, USA.
FAU - Barringhaus, Kurt G
AU  - Barringhaus KG
AD  - Cardiology, Palmetto Health-USC Medical Group, 8 Medical Park Dr Ste 100, 
      Columbia, SC 29203, USA.
AD  - Department of Internal Medicine, Cardiology Division, University of South 
      Carolina School of Medicine, 6311 Garners Ferry Road, Columbia, SC 29209, USA.
FAU - Feldman, Barry
AU  - Feldman B
AD  - Cardiology, Palmetto Health-USC Medical Group, 8 Medical Park Dr Ste 100, 
      Columbia, SC 29203, USA.
AD  - Department of Internal Medicine, Cardiology Division, University of South 
      Carolina School of Medicine, 6311 Garners Ferry Road, Columbia, SC 29209, USA.
FAU - Vismara, Vince
AU  - Vismara V
AD  - Cardiology, Palmetto Health-USC Medical Group, 8 Medical Park Dr Ste 100, 
      Columbia, SC 29203, USA.
AD  - Department of Internal Medicine, Cardiology Division, University of South 
      Carolina School of Medicine, 6311 Garners Ferry Road, Columbia, SC 29209, USA.
FAU - Baker, Deborah
AU  - Baker D
AD  - Johns Hopkins University School of Nursing, 525 N Wolfe St, Baltimore, MD 21205, 
      USA.
LA  - eng
GR  - T32 NR012704/NR/NINR NIH HHS/United States
PT  - Journal Article
PL  - England
TA  - Eur J Cardiovasc Nurs
JT  - European journal of cardiovascular nursing
JID - 101128793
SB  - IM
MH  - *Acute Coronary Syndrome/complications/surgery
MH  - Humans
MH  - Patient Discharge
MH  - *Percutaneous Coronary Intervention/adverse effects
MH  - Risk Factors
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Coronary Intervention
OT  - Implementation science
OT  - NSTE-ACS
OT  - Process improvement
EDAT- 2021/03/13 06:00
MHDA- 2022/04/01 06:00
CRDT- 2021/03/12 07:25
PHST- 2020/05/03 00:00 [received]
PHST- 2020/09/20 00:00 [revised]
PHST- 2020/10/31 00:00 [accepted]
PHST- 2021/03/13 06:00 [pubmed]
PHST- 2022/04/01 06:00 [medline]
PHST- 2021/03/12 07:25 [entrez]
AID - 6168591 [pii]
AID - 10.1093/eurjcn/zvaa029 [doi]
PST - ppublish
SO  - Eur J Cardiovasc Nurs. 2021 Oct 27;20(7):660-666. doi: 10.1093/eurjcn/zvaa029.