Introducing Same Day Discharge for Elective PCI Blog Series: Discover the Importance of Same Day Discharge from Leading Experts
October 5, 2020
Here at Terumo Business Edge, we are very excited to bring you a series of blogs on the importance and growing utilization of same day discharge (SDD) within cardiac catheterization lab, specifically within the acute care hospital setting. Historically, when it comes to performing elective percutaneous coronary interventions (PCI), the patient is admitted the day of the procedure and discharged the following day. In the majority of cases, patients proceed through the procedure with no untoward events and the rationale for the overnight stay was again a historical hold over from the pre-transradial era whereby concerns regarding potential access bleeding from the femoral artery was mitigated through overnight observation. With the advent of transradial access, progressive providers and hospitals realized patients could be safely discharged the same day of procedure.
Interestingly, there are still hold over misconceptions that continue to persist as it relates to whether the hospital is compensated for this observation period of overnight stay. They are not. It is important to note that Medicare, as the largest payer for PCI procedures, recognized over a decade ago that they were potentially paying higher DRG inpatient payments that were not supported by medically necessary documentation. This resulted in what we all know were the recovery audit contractors (RAC), which ultimately drove hospitals to shift their coding to the outpatient APC process; however, even today the majority of hospitals continue to keep patients overnight while getting paid a lower reimbursement.
Enter the COVID virus and the cessation of elective procedures and we have the setting for a healthcare system that now must be more efficient, more cost effective, and able to provide the safest, most patient assured environment, something same day discharge can deliver on all accounts. Here at Terumo Business Edge we are helping our customers make the shift to same day discharge. SDD is more cost effective. Amin, et.al. in their publications have demonstrated a cost benefit to SDD and when combined with transradial access there are even greater cost and operational benefits. In the coming days and weeks, please join us for our various guest physicians and administrators as they discuss the importance of SDD and transradial in their practices and their hospitals.
About the Author
Terumo Health Outcomes
Gary has an extensive 35-year cardiovascular background, encompassing work in cath labs, open heart surgery, cardiac pacing, education, marketing and business development. While working at Terumo he developed, launched and managed the introduction of transradial procedures in the US, evolving a market adoption that has grown from 2% to 40% over the past ten years. He has worked with countless healthcare professionals to generate the overwhelming body of evidence supporting the clinical, economic and patient benefits of transradial access. As a result, he was tasked with evolving a business unit that could assist hospitals in becoming more economically viable by implementing care pathways that leverage cost-effective delivery of care.