The Why and How of Same Day Discharge

The ‘Why’ and ‘How’ of Same Day Discharge with Transradial Access for PCI Amit Amin MD MS Washington University School of Medicine, St. Louis, MO PM-01669

Disclosures • NIH KM 1 award, Grant Number 1 KM 1 CA 156708 -01; • AHRQ R 18 award, Grant Number R 18 HS 0224181 -01 A 1; • Consultant Terumo, and Astra. Zeneca. PM-01669

Terumo Medical Corporation Disclaimer The opinions expressed by Dr. Amin during this presentation are his own and do not necessarily reflect those of Terumo Medical Corporation. Unattributed data, device selection and procedural guidance is a matter of physician preference and opinion derived from Dr. Amin’s own observations and experiences and should be treated accordingly. All visual representations and other imagery contained in this presentation are used with permission from Dr. Amin RX ONLY. Refer to the product labels and package insert for complete warnings, precautions, potential complications, and instructions for use. PM-01669

PM-01669 Amin AP et al. JACC Cardiovasc Interv. 2013 Aug; 6(8): 827 -34.

Adjusted Costs of Radial PCI: From 5 US Hospitals $16, 000 $15, 784 Δ $ 830 favoring radial PCI $15, 500 P < 0. 001 $15, 000 $14, 954 $14, 500 $14, 000 PM-01669 Radial Femoral Amin AP et al. JACC Cardiovasc Interv. 2013 Aug; 6(8): 827 -34.

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Current Hospital Costs of PCI: the PCI Care Pathway PM-01669 Amin AP et al. JACC Intv. 2017

Current Hospital Costs of PCI: the PCI Care Pathway Δ $ 3, 600 favoring radial SDD PCI PM-01669 Amin AP et al. JACC Intv. 2016

Cost savings to a hospital performing 1, 000 elective PCI procedures annually, when converting from the current pathway of TFI NSDD to TRI SDD PM-01669 Amin AP et al. JACC Intv. 2016

PM-01669 JAMA Cardiol. 2018; 3(11): 1041 -1049. doi: 10. 1001/jamacardio. 2018. 3029

Premier Data N=672, 000 PCIs PM-01669

PM-01669 Premier Data N=672, 000 PCIs

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BJH Same Day Discharge Program PM-01669

Same Day Discharge (~70%) has reduced LOS and Cost • Our unique “patient-centered approach” to SDD: • Provides us the ability to perform SDD even when PCI complexity is high PM-01669 Amin AP et al. JAHA March 2018

Prevalence of Comorbidities and Lesion Complexity among Same Day Discharges 80% 68% 67% 63% 60% 36% 40% 28% 26% 20% 0% PM-01669 Type C Long SVG graft Diabetes lesion > 20 mm CHF CVD 18% PVD COPD Amin AP et al. JAHA March 2018

Patient Satisfaction is High with SDD 100% 88% 82% 75% 50% 25% 19% 12% 0% Excellent Care - No Excellent Care - Yes Extremely Satisfied - No Satisfied - Yes PM-01669 Amin AP et al. JAHA March 2018

Lower Spend with SDD PM-01669 Amin AP et al. JAHA March 2018

PM-01669 Amin AP et al. JAHA March 2018

Thank you! PM-01669