The bare minimum of information at discharge after acute coronary syndrome. Part 2: the quality improvement project

An Acute Coronary Syndrome is a fine example of the communicative difficulties that precede and characterize hospital discharge. In recent years, due to the rapid changes in therapeutic approaches, hospitalizations have become extremely brief. This entails the risk of inadequate information at discharge, significantly affecting the quality of treatment compliance and the adoption of lifestyle modifications for an effective secondary prevention. There are a series of issues that the health practitioner should cover at discharge with the patient and family members: history of disease and prognosis, risk factors and strategies for their control, aims of treatment, instructions on drugs, diet and physical activity, need for medical check-up; and, last but not least, to verify that the information has been understood. Information on drug treatment is all too often left to patient's interpretation of hearsay or of the discharge letter, the new drug regime can easily be misunderstood or arbitrarily integrated into pre-existing drug regimes. Health practitioners must discuss issues, regardless of whether they are asked direct questions; and they should verify what imparted information has been correctly understood and assimilated. A rapid turn-over is crucial to the organization of acute units, therefore we need to identify a solution that ticks all the boxes of a good discharge in a reasonably brief time. Imparting information should be an integral component of care delivery, and the responsible practitioners (doctors and/or nurses) should be identified. We propose a standardized discharge form, containing the essential information, as a point of reference to be applied in different clinical settings

[The bare minimum of information at discharge after acute coronary syndrome. Part 1: Factors that affect communication].

Hospital discharge after an Acute Coronary Syndrome represents a potential pitfall for patients. Strict adherence to discharge instructions is sometimes essential for recovery and prevention of complications and patients' knowledge of diagnosis and treatment plan is an integral component of patient education. Discharge communication is an integral part of high-quality, patient-centered care but patients leaving hospital often fail to understand important elements of their discharge and home care plan. This paper describes the existing literature on patient understanding and implementation of discharge instructions, discusses previous interventions aimed at improving the discharge process, and recommends best practices

Cardiac rehabilitation activities during the COVID-19 pandemic in Italy. Position Paper of the AICPR (Italian Association of Clinical Cardiology, Prevention and Rehabilitation)

The COVID-19 outbreak is having a significant impact on both cardiac rehabilitation (CR) inpatient and outpatient healthcare organization. The variety of clinical and care scenarios we are observing in Italy depends on the region, the organization of local services and the hospital involved. Some hospital wards have been closed to make room to dedicated beds or to quarantine the exposed health personnel. In other cases, CR units have been converted or transformed into COVID-19 units. The present document aims at defining the state of the art of CR during COVID-19 pandemic, through the description of the clinical and management scenarios frequently observed during this period and the exploration of the future frontiers in the management of cardiac rehabilitation programs after the COVID-19 outbreak

Cardiac Prevention and Rehabilitation “3.0”: From acute to chronic phase. Position Paper of the ltalian Association for Cardiovascular Prevention and Rehabilitation (GICR-IACPR)

Cardiac rehabilitation (CR) is the subspecialty of clinical cardiology dedicated to the treatment of cardiac patients, early and in the long term after an acute event. The aim of CR is to improve both quality of life and prognosis through prognostic stratification, clinical stabilization and optimization of therapy (pharmacological and non), management of comorbidities, treatment of disability, as well as through the provision and reinforcement of secondary prevention interventions and maintenaince of adherence to treatment. The mission of CR has changed over time. Once centered on the acute phase, aimed primarily at short-term survival, the healthcare of cardiac patients now increasingly involves the chronic phase where the challenge is to guarantee continuity and quality of care in the medium and long-term. The aim of the present position paper is to provide the state-of-the-art of CR in Italy, discussing its trengths and weaknesses as well as future perspectives