Lessons learnt from the implementation of same-day discharge after percutaneous coronary intervention

Area of Science:

• Healthcare Management
• Cardiology
• Health Services Research

Background:

• Same-day discharge following percutaneous coronary intervention (PCI) is a safe and effective alternative to overnight stays.
• Despite evidence supporting its benefits, the adoption of same-day discharge protocols remains low in clinical practice.
• Organizational change in healthcare requires adequate resources for successful implementation.

Purpose of the Study:

• To identify factors influencing the implementation of same-day discharge after PCI.
• To explore barriers and facilitators to adopting this practice in a tertiary hospital setting.

Main Methods:

• An interpretive study utilizing semistructured interviews with 26 healthcare professionals.
• Conducted in an Australian tertiary hospital's cardiac catheterisation suite from June to December 2016.
• Content analysis was guided by the theoretical domains framework.

Main Results:

• Key influencing domains included beliefs about consequences, professional role, resources, behavior regulation, and optimism.
• Healthcare professionals acknowledged benefits but expressed concerns regarding safety and eligibility criteria.
• Lack of dedicated resources, unclear roles, and differing understanding of guidelines hindered implementation.

Conclusions:

• Successful implementation of same-day discharge requires a clear plan, stakeholder involvement, and dedicated resources (time, personnel, change management expertise).
• Addressing professionals' beliefs, roles, and resource availability is crucial for overcoming barriers.
• Policymakers can use these insights to design effective interventions for improving same-day discharge rates.