Abstract 20916: See You in 7: An Advanced Practice Provider Post PCI Clinic Improving Transition of Care
Introduction/Background: There has been a practice change when treating elective PCI patients. Patients are now being discharged on the same day of the procedure. This change in practice has limited the exposure of the patient to the physician and healthcare team resulting in fragmented and uncoordinated care.
Purpose/Objective: The purpose of this process improvement project was to review our current same day PCI discharge process and to implement procedures to improve outpatient care coordination and transition. This would be accomplished by creating an integrated discharge and follow up process, aimed at improving medication safety, referral to cardiac rehab and compliance.
Methods: A multidisciplinary team utilized lean principles to develop a patient centered transitional care program, “See You in 7". This advanced practice provider (APP) run clinic would ensure patients received appropriate coordinated services required to manage their CAD. A sample of pre and post implementation metrics included number of scheduled visits within 30 days of discharge, medication errors (actual or near misses), referral and enrollment into cardiac rehab.
Results: The retrospective review of six months of same day PCI data included 153 patients. The average day(s) to follow up with a cardiology provider was 47 and 9.5% of patients still have not been seen in cardiology clinic at 12 months. Only 21 % of patients were engaged in cardiac rehab within 30 days of discharge and 11% had medication errors. Following implementation of phase one of the transitional care program the average days to follow up was 4 days. There have been no medication errors to date and cardiac rehabilitation participation has increased to 80%. An economic analysis of revenue not captured (FU visits, participation in cardiac rehab, avoiding admission to the ER) demonstrates that this APP clinic is revenue generating for both the practice and hospital.
Author Disclosures: C. Shallow: None.
- © 2016 by American Heart Association, Inc.