Proposal for a standardized discharge letter after hospital stay for acute myocardial infarction

Author:

Schiele Francois1,Lemesle Gilles2345,Angoulvant Denis6,Krempf Michel7,Kownator Serge8,Cheggour Saida9,Belle Loic10,Ferrières Jean11,Bauters Christophe,Bergerot Cyrille,Beygui Farzin,Boccara Franck,Bonnefoy Eric,Bruckert Eric,Cayla Guillaume,Collet Jean-Philippe,Coste Pierre,Descotes-Genon Vincent,Ducrocq Gregory,Elbaz Meyer,Farnier Michel,Ferrari Emile,Guedj Dominique,Levai Laszlo,Mansourati Jacques,Mansencal Nicolas,Meneveau Nicolas,Meune Christophe,Morel Olivier,Ohlmann Patrick,Paillard Francois,Piot Christophe,Puymirat Etienne,Rioufol Gilles,Roubille François,Sabouret Pierre,Teiger Emmanuel

Affiliation:

1. Department of Cardiology, University Hospital Besancon, and EA3920, University of Franche-Comté, Besancon, France

2. USIC et Centre Hémodynamique, Institut Cœur Poumon, Centre Hospitalier Universitaire de Lille, France

3. Faculté de Médecine de l’Université de Lille, France

4. INSERM UMR 1011, Institut Pasteur de Lille, France

5. FACT (French Alliance for Cardiovascular Trials), Paris, France

6. Service de cardiologie, faculté de médecine, université François-Rabelais, CHU Trousseau, Tours

7. CHU de Nantes-Hôpital Nord Laennec, Saint Herblain, France

8. Centre cardiologique et vasculaire, Thionville, France

9. Centre Hospitalier Henri Duffaut, Avignon, France

10. Service de Cardiologie, Centre Hospitalier Annecy-Genevois, Metz-Tessy, France

11. Service de Cardiologie B, CHU Rangueil, Toulouse, France

Abstract

Abstract In patients admitted for acute myocardial infarction, the communication and transition from specialists to primary care physicians is often delayed, and the information imparted to subsequent healthcare providers (HCPs) may be sub-optimal. A French group of cardiologists, lipidologists and diabetologists decided to establish a consensus to optimize the discharge letter after hospitalization for acute myocardial infarction. The aim is to improve both the timeframe and the quality of the content transmitted to subsequent HCPs, including information regarding baseline assessment, procedures during hospitalization, residual risk, discharge treatments, therapeutic targets and follow-up recommendations in compliance with European Society of Cardiology guidelines. A consensus was obtained regarding a template discharge letter, to be released within two days after patient’s discharge, and containing the description of the patient’s history, risk factors, acute management, risk assessment, discharge treatments and follow-up pathway. Specifically for post acute MI patients, tailored details are necessary regarding the antithrombotic regimen, lipid-lowering and anti-diabetic treatments, including therapeutic targets. Lastly, the follow-up pathway needs to be precisely mentioned in the discharge letter. Additional information such as technical descriptions, imaging, and quality indicators may be provided separately. A template for a standardized discharge letter based on 8 major headings could be useful for implementation in routine practice and help to improve the quality and timing of information transmission between HCPs after acute MI.

Publisher

Oxford University Press (OUP)

Subject

Cardiology and Cardiovascular Medicine,Critical Care and Intensive Care Medicine,General Medicine

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