Day-stay for Paediatric Cardiac Catheterisation Measuring the Impact

Abstract

Aim: To describe the impact of the implementation of a day-stay cardiac catheterisation care pathway on length of hospital stay, hospital re-admissions post day-stay and level of parental satisfaction with this approach. Background: There is an international trend towards increasing numbers of paediatric procedures being performed on a day-stay basis. Corresponding with this shift in practice, the sole New Zealand provider of Paediatric Cardiac services implemented a pathway to undertake cardiac catheterisation utilising a day-stay approach in select patients. Methods: Two quantitative studies were undertaken utilising observational designs. Data was collected over the initial five month period of the day-stay pathway implementation. The organisational impact study assessed the impact through comparing a sample of ninety three elective cardiac catheter patients post the care pathway implementation in 2011 to a baseline sample of sixty nine patients in the same time period the year prior to the pathway implementation. The parental impact study comprised a sample of nineteen parents who consented to complete the anonymous written questionnaire developed specifically for this study. Findings: A significant increase in the day-stay rates from 2010 to 2011, from 2.9% to 22.6% (p-value 0.000) was reported. A significant decrease in length of hospital stay was identified between 2010 and 2011 (p-value 0.001). In the 2011 sample there were twenty one day-stay paediatric cardiac catheterisation patients. The mean length of stay for the day-stay patients was 25.49 hours less than those treated as inpatients (p-value 0.000). No patients were re-admitted post discharge on the same day as their cardiac catheterisation. The parental impact questionnaire response rate was 47%. Study participants reported a high level of satisfaction with the day-stay approach, 89% identified they would prefer discharge on the same day as their child’s cardiac catheterisation as opposed to overnight hospital stay. Conclusion: This research portfolio demonstrated the positive impact of the day-stay care pathway on length of hospital stay and parent satisfaction for paediatric patients with CHD undergoing cardiac catheterisation. Paediatric day-stay patients stay a significantly shorter time in hospital than those treated as inpatients and parents demonstrate a high level of satisfaction with this approach.