Same-day discharge strategy in a heart rhythm management clinic: The patient-reported experience

Background: Same-day discharge (SDD) has been adopted for interventional cardiology procedures, however, data on patient experience are scarce.

Aims: To investigate patient-reported experience after various SDD electrophysiology procedures.

Methods: Consecutive patients undergoing electrophysiology procedures, who fulfilled pre-defined eligibility criteria for SDD, completed the questionnaire before discharge. Procedures suitable for SDD included non/minimally-invasive (e.g. electric cardioversions, tilt tests) and invasive procedures (e.g. cardiac device replacements, catheter ablations). The questionnaire assessed patient experience before and during the procedure, satisfaction with the provided information and understanding of the discharge instructions.

Results: The questionnaire was completed by 501 patients (57.5% men). Invasive procedures accounted for 56.7% of SDD procedures. Most patients (88.9%) described SDD as a good or quite good experience, while 95.3% would not hesitate to undergo a second SDD procedure if necessary. A direct interview with a healthcare team member was the preferred method of obtaining information. At discharge, a considerable number of patients were unsure about the provided instructions, including those related to anticoagulation. Patient-reported satisfaction did not differ between invasive and non/minimally-invasive procedures (P=0.06). However, after an invasive procedure, patients had a better understanding of discharge instructions (59.5% vs 41.9%; P<0.001). Most patients who underwent a procedure under general anaesthesia reported a good or quite good experience (87.7% vs 84.2% of sedation patients; P=0.16).

Conclusion: SDD was generally a positive experience for patients undergoing invasive or non/minimally-invasive procedures. However, discharge instructions and patient understanding require improvement.