SINGAPORE — The National University Heart Centre, Singapore (NUHCS) is improving the way patients recover from elective heart procedures by introducing a “Same-Day Discharge” service for those undergoing coronary interventions, such as balloon angioplasty and stenting. Traditionally, these patients are warded overnight for observation. With the Same-Day Discharge model, clinically eligible patients can now return home within hours after their procedures, offering greater comfort, convenience and cost savings.
In 2024, more than 200 patients have benefitted from the service at NUHCS across the National University Hospital (NUH) and Ng Teng Fong General Hospital (NTFGH).
The new Same-Day Discharge service maintains the same standard of care and has been shown to be as safe as the traditional overnight stay model, with no adverse effects on patient recovery. A study by the angiography nursing team at NUHCS, led by Assistant Nurse Clinician Yap El Fuon, found no difference in cardiovascular outcomes between patients discharged on the same day and those who stayed overnight in the hospital. These outcomes include death, heart attacks, vascular access site complications, and urgent re-admissions.
This finding is in line with an international study in 2021, which found that clinical outcomes for Same-Day Discharge and traditional overnight stays after coronary heart interventions are comparable.1
Assistant Professor Gavin Ng, Clinical Director of the Interventional Cardiology and Angiography Centre, NUHCS, explained that Same-Day Discharge patients are offered the same comprehensive post-discharge services as those staying overnight. This includes access to NUHCS’s cardiac rehabilitation programme and a follow-up teleconsultation with the medical team the day after discharge to monitor their recovery progress.
“Same-Day Discharge enhances the patient experience without compromising safety. It also offers cost-saving benefits to our patients in terms of hospitalisation expenses, and helps us manage inpatient bed capacity more efficiently,” says Asst Prof Ng, who is also a Consultant in the Department of Cardiology at NUHCS.
The Same-Day Discharge service is offered to all eligible elective patients undergoing coronary interventions, and patients can still opt for overnight stays if preferred. Eligibility for the service is dependent on several pre-requisites pertaining to clinical stability and the availability of a caregiver at home. The eligibility checklist includes:
“The Same-Day Discharge service offers patients greater comfort and a more seamless transition from hospital to home. With detailed post-discharge advice and access to telehealth support, patients feel well-prepared to continue their recovery at home,” says Ms Yap. “We have received positive feedback, with most patients and their families expressing their preference to rest in the comfort of their home.”
Following the success with coronary interventional procedures, the initiative is being progressively rolled out for selected pacing and electrophysiology procedures at NUHCS.
The Same-Day Discharge initiative is part of ongoing efforts to deliver high-quality, patient-centred care at NUHCS. As the team continues to assess the expansion of the service to other procedures, it underscores NUHCS’s commitment to deliver efficient and evidence-based care that aligns with evolving healthcare needs.
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1Rao, S, Vidovich, M, Gilchrist, I. et al. 2021 ACC Expert Consensus Decision Pathway on Same-Day Discharge After Percutaneous Coronary Intervention: A Report of the American College of Cardiology Solution Set Oversight Committee. JACC. 2021 Feb, 77 (6) 811–825. https://doi.org/10.1016/j.jacc.2020.11.013
