Outcomes of same day discharge after percutaneous coronary intervention: A quality improvement project

Background: Literature about how same day discharge following percutaneous coronary intervention influences patient and organisational outcomes, especially length of stay and outpatient cardiac rehabilitation attendance, is limited. Aim: The study aimed to evaluate patient and organisational outcomes after implementing same day discharge in one Australian tertiary hospital. Methods: An uncontrolled before and after study design was adopted. Data on patient and organisational outcomes from patients who underwent percutaneous coronary intervention 6 months in the pre-implementation (n = 66) and 6 months in the post-implementation periods (n = 82) were compared. In the post-implementation period, subgroups of same day discharge patients (n = 19) and overnight stay patients (n = 63) were compared for the same outcome data. Results: When comparing overnight stay, same day discharge contributed to reduced length of stay (21 hours) and cost-savings ($2,546) per patient, which were statistically significant. However, the low implementation rate (23.2%) meant that the length of stay and healthcare costs were similar in the pre- and post-implementation groups. Although non-statistically significant, same day discharge patients had a higher rate of outpatient cardiac rehabilitation attendance than overnight stay patients. Post-procedure complications or readmissions were similar between the groups. Discussion and conclusion: While same day discharge resulted in reduced length of stay and healthcare costs, more patients must be discharged the same day before a meaningful impact on healthcare delivery will be realised. Encouragingly, a higher proportion of same day discharge patients attended outpatient cardiac rehabilitation than overnight stay patients. More research is warranted to investigate further how same day discharge impacts on outpatient cardiac rehabilitation attendance.