Increasing the Number of Same-Day Stent Discharges from the Cardiac Cath Lab

According to published research data, the majority of cardiac stent patients have no additional risk of complications if they are discharged the same day as their procedure versus the following day. Given resource limitations—both staff related and financial—at health care facilities and the fact that patients prefer to go home rather than spend a night in the hospital, it makes sense to discharge qualified patients on the same day as their procedure.

Before the project was started, each month HSHS St. John's Hospital was sending home an average of 37 percent of patients on the same day of their procedure. The project goal was to reach 50 percent same-day discharges within the first 12 months by focusing on increasing radial access percutaneous coronary interventions (PCIs), which require a shorter recovery period. The project involved scheduling PCIs earlier in the day whenever possible and educating physicians.

Within the first month, the hospital was able to reach its goal, and over the next several months, the percentage of patients being discharged on the same day continued to increase. Within six months of implementation, the hospital was able to send 91 percent of patients home the same day as their procedure. Furthermore, there were no additional complications or readmissions, and patient satisfaction scores improved.

This case study is part of the Illinois Health and Hospital Association's annual Quality Excellence Achievement Awards. Each year, IHA recognizes and celebrates the achievements of Illinois hospitals and health systems in continually improving and transforming health care in the state. These organizations are improving health by striving to achieve the Triple Aim—improving the patient experience of care (including quality and satisfaction), improving the health of populations, and reducing the per capita cost of health care—and the Institute of Medicine's six aims for improvement—safe, effective, patient centered, timely, efficient, and equitable. To learn more, visit https://www.ihaqualityawards.org/javascript-ui/IHAQualityAward/