Research

Optimizing Same-Day Discharge for CV Procedures

Same-day discharge for cardiovascular procedures is a growing priority. An accelerating outpatient shift, associated with reimbursement decreases, mandates focus on efficiency and throughput. This is ideally accomplished through same-day discharge.

However, many institutions do not have the physician buy-in, consistent criteria, and infrastructure requirements in place to enable same-day discharge. This briefing outlines six lessons to overcome these barriers and hardwire same-day discharge.

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6 lessons for optimizing same-day discharge

1. Demonstrate safety and efficacy with data (p. 10)
Sharing hospital-specific and general data on complications can alleviate physician concerns about same-day discharge.

2. Formally incentivize behaviors that promote same-day discharge (p. 14)
Attaching same-day discharge to at-risk pay can help overcome the force of old practice patterns.

3. Set clear criteria for every stage of care (p. 20)
Initial same-day discharge eligibility criteria should extend throughout the day to reflect potential changes in patient status.

4. Integrate non-clinical factors into eligibility assessments (p. 22)
Patients’ social determinants of health influence their ability to thrive after same-day discharge—so hardwire these factors into your evaluations.

5. Reconfigure the cath lab schedule (p. 23)
Prioritize morning appointments for likely same-day discharge candidates to increase the program’s ability to discharge patients in a timely manner.

6. Alter post-procedure infrastructure (p. 24)
Appropriate recovery setting, staffing models, and discharge plans can all enable same-day discharge for eligible patients.


Supporting resources from peer organizations

St. Joseph Mercy Health System
Same-Day Discharge PCI Follow-Up Phone Call Instructions
Same-Day Discharge PCI Flowchart

Providence Health and Services
Pathway and Criteria for Same-Day Discharge for Elective PCI

Felton Hospital
Criteria for Selection of Patients for Same-Day Discharge after PCI

CHI Franciscan Harrison Medical Center
Eligibility Criteria for Pacemaker Same-Day Discharge
Same-Day Discharge Protocol for PCI

Granger Hospital
Same-Day Discharge PCI Checklist

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