Day of Discharge Doesn't Affect Guideline Compliance

Weekend and weekday staff provide acute coronary syndrome patients with same quality of care
By Pat F. Bass, M.D.
HealthDay Reporter

MONDAY, Sept. 15 (HealthDay News) -- Staff adherence to guideline recommendations when treating patients hospitalized with acute coronary syndrome is not affected by day of discharge (weekday versus weekend), researchers report in the Sept. 15 issue of the American Journal of Cardiology.

Sumit Tickoo, M.D., of Danbury Hospital in Danbury, Conn., and colleagues compared implementation of guideline recommendations for acute coronary syndrome performance measures on weekends/holidays and weekdays. The study included 154,910 patients from the American Heart Association's Get with the Guidelines (GWTG) - Coronary Artery Disease database who were admitted to 515 hospitals with acute coronary syndrome over a seven-year period.

Overall, patients discharged on weekdays tended to be women, older, have a history of atrial fibrillation, cerebral vascular accident/transient ischemic attack and chronic renal insufficiency, and present with unstable angina. With the exception of receiving angiotensin-converting enzyme inhibitors (68.3 percent of those discharged on weekends/holidays versus 69.5 percent discharged on weekdays), there were no significant differences in guideline compliance for patients discharged on weekends/holidays and those discharged on weekdays, the researchers report. A composite measure of 100 percent compliance was not significantly different between the two groups (81.5 versus 81.4 percent).

"In conclusion, within GWTG participating hospitals, weekend/holiday staffing provides the same quality of care in acute coronary syndrome for discharge medications and counseling compared with full weekday staffing," the authors write. "Thus, among GWTG-Coronary Artery Disease participating hospitals, hospital staffing and physician coverage on the day of discharge does not significantly influence the overall provision of guideline-recommended therapies and patient education as judged by explicit performance measures."

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