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Developing a Same-Day Discharge Clinical Pathway for Patients Undergoing Elective Percutaneous Coronary Intervention Using a Nominal Group Technique - 06/01/26

Doi : 10.1016/j.hlc.2025.07.006 
Yingyan Chen, PhD a, b, , Jacqueline Peet, PhD b, c, Natalie Hausin, MSc d, David Hinds, GradDipNurs(CritCare) e, Rohan Jayasinghe, MBBS f, g, h, Wendy Kennedy, MSc i, Suzanne Morris, MSc f, Rohan Poulter, MBBS j, k, Gregory Starmer, MBBS d, Yash Singbal, MBBS i, l, Anna Townsend, MSc m, Paul Wallis, GDipCritCareNurs j, Raibhan Yadav, FRACP e, n, Zhihua Zhang, MBBS m, Karen Wardrop, CertNursing o, Junel Padigos, PhD p, q, Frances Fengzhi Lin, PhD b, r, s
a School of Nursing and Midwifery, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Vic, Australia 
b School of Health, University of the Sunshine Coast, Sippy Downs, Qld, Australia 
c Caboolture, Kilcoy and Woodford Corrective Hospital and Health Service, Caboolture, Qld, Australia 
d Cardiology Department, Cairns Hospital, Cairns City, Qld, Australia 
e Cardiology Department, The Townsville Hospital, Douglas, Qld, Australia 
f Cardiology Department, Gold Coast University Hospital, Southport, Qld, Australia 
g School of Medicine, Griffith University, Southport, Qld, Australia 
h School of Medicine, Macquarie University, Sydney, NSW, Australia 
i Cardiology Department, Princess Alexandra Hospital, Woolloongabba, Qld, Australia 
j Cardiology Department, Sunshine Coast University Hospital, Birtinya, Qld, Australia 
k School of Medicine, Griffith University, Nathan, Qld, Australia 
l School of Medicine, The University of Queensland, Woolloongabba, Qld, Australia 
m Cardiology Department, Mackay Base Hospital, Mackay, Qld, Australia 
n School of Medicine, James Cook University, Townsville, Qld, Australia 
o Consumer Representative 
p School of Nursing, Midwifery and Social Sciences, Central Queensland University, Cairns, Qld, Australia 
q Intensive Care Unit, Sunshine Coast University Hospital, Birtinya, Qld, Australia 
r Caring Futures Institute, Flinders University, Adelaide, SA, Australia 
s College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia 

Corresponding author at: School of Nursing and Midwifery, Faculty of Medicine, Nursing and Health Sciences, Monash University, Wellington Rd, Clayton, VIC 3800, Australia School of Nursing and Midwifery Faculty of Medicine Nursing and Health Sciences Monash University Wellington Rd Clayton VIC 3800 Australia

Abstract

Background

Same-day discharge (SDD) following elective percutaneous coronary intervention (PCI) has gained popularity; however, uptake varies worldwide, and existing SDD consensus documents have largely been developed without input from clinicians and consumers. We aimed to develop an SDD clinical pathway in collaboration with clinicians, patients, and carers.

Method

This was a mixed-methods study. The AGREE II instrument was used to guide the development of the SDD clinical pathway to ensure rigour. A hybrid workshop, allowing both online and in-person attendance, was conducted with participants from six public hospitals in Queensland, Australia. The project funded all participants’ travel to the workshop to maximise in-person attendance. A modified seven-step nominal group technique was used to guide the workshop and refine the clinical pathway. Sessions in Step 4 (participants presented ideas one by one) and Step 5 (researchers provided clarification) were audio-recorded and transcribed verbatim. Deductive content analysis was undertaken. We counted and recorded numbers for quantitative data.

Results

A total of 15 participants took part in the study, including nurses (n=6), medical officers (n=5), patients (n=3), and a carer representative (n=1). Consensus was achieved for six out of seven pre-PCI factors, all 14 post-PCI factors, all nine pre-discharge checklist statements, and all five risk management statements. All participants agreed that, despite the consensus, the final SDD decision should remain with the interventional cardiologist performing the procedure.

Conclusions

Our approach has demonstrated that the developed clinical pathway is not only evidence-based but also considers contextual factors and the needs of consumers. It will assist clinicians in making decisions about SDD in hospitals, thereby enhancing the efficiency of cardiac service delivery and improving patient satisfaction.

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Keywords : Consensus-based clinical pathway, Clinical pathway development, Nominal group technique, Patient involvement, Percutaneous coronary intervention, Same-day discharge


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P. 116-126 - gennaio 2026 Ritorno al numero
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