A Novel Protocol for Very Early Hospital Discharge After STEMI

Although the incidence of ST-elevation myocardial infarction (STEMI) is on the decline, management of patients who present with STEMI continues to require significant health care resources. Earlier hospital discharge in low-risk patients who present with STEMI has been an area of focus in an attempt to reduce health care costs. As a result, discharge within 48-72 hours after successful primary percutaneous coronary intervention has increasingly become routine practice. Moreover, the current COVID-19 pandemic has led to enormous pressure on health care systems to find ways to increase bed capacity, preserve resources, and reduce the risk of exposure to patients and health care workers. In response to this goal, the Ottawa Heart Institute has developed and implemented a novel Very Early Hospital Discharge (VEHD) protocol. The VEHD protocol is a simple, 4-step algorithm designed to accurately and efficiently identify low-risk STEMI patients who can be safely discharged between 20 and 36 hours after successful primary percutaneous coronary intervention. When deemed eligible for VEHD predischarge tasks are completed by the treating medical and nursing team and the patient is discharged home. Follow-up is completed remotely via virtual care (48 hours, 7 days, 30 days), and in the outpatient cardiology clinic (4-6 weeks). Amid a worldwide COVID-19 pandemic we believe the VEHD protocol is a crucial step in maintaining exceptional quality of care, in terms of patient satisfaction and clinical outcomes, while concurrently decreasing the risk of nosocomial infections, and reducing resource utilization. Bien que l’incidence de l’infarctus du myocarde avec élévation du segment ST (STEMI) soit en déclin, la prise en charge des patients qui subissent un STEMI exige encore des ressources importantes en matière de soins de santé. La sortie d’hôpital précoce des patients qui subissent un STEMI, mais qui sont exposés à un faible risque, a retenu l’attention dans le but de réduire les coûts des soins de santé. Par conséquent, la sortie d’hôpital dans les 48 à 72 heures après la réalisation d’une intervention coronarienne percutanée primaire est en constante augmentation dans la pratique courante. De plus, la pandémie actuelle de COVID-19 a entraîné une énorme pression sur les systèmes de santé pour trouver des moyens pour augmenter le nombre de lits, préserver les ressources et réduire le risque d’exposition des patients et des travailleurs de la santé. En réponse à cet objec