Improving same-day discharge after catheter ablation procedures: the Hawthorne effect or an epiphenomenon of the COVID-19 pandemic?

Abstract: Same-day discharge after catheter ablation procedures may improve patient flow and reduce hospital costs. Despite this, same-day discharge is underutilized in multiple jurisdictions globally. Strategies to improve same-day discharge have not been reported. Altering physician behavior is necessary to facilitate change. In this quality improvement study, we evaluated the utility of a monthly email on increasing same-day discharge after a supraventricular tachycardia (SVT) ablation procedure. To assess for a Hawthorne effect we evaluated changes in the rate of same-day discharge for ablation procedures for an unrelated arrhythmia—atrial fibrillation (AF). Additional analyses were performed in an attempt to account for the impact of the coronavirus disease 2019 (COVID-19) pandemic which coincidentally occurred during our study period. We noted an increase in same-day discharge for SVT ablation procedures during the intervention period. Incidentally, we noted an increase in same-day discharge for the alternative arrhythmia mechanism (AF ablation). While we speculate that the increase in the use of same-day discharge for AF ablation was due to the Hawthorne effect, analyses accounting for the rate of increase in same-day discharge by different epochs during the time of the COVID-19 pandemic suggest that the COVID-19 pandemic may have had an important influence on the use of same-day discharge after catheter ablation procedures. Our work demonstrates one approach to improve same-day discharge after catheter ablation procedures.