Implementing an atrial fibrillation pathway – Jun 14, 2018
EM Network Member David Barbic collaborated with CanadiEM and the Canadian Journal of Emergency Medicine (CJEM) to create a visual abstract on his article: “Implementation of an emergency department atrial fibrillation and flutter pathway improves rates of appropriate anticoagulation, reduces length of stay and thirty-day revisit rates for congestive heart failure”, published in May 2018.
Atrial fibrillation and flutter are arrhythmias that come with significant morbidity and mortality. Barbic et al. examined the effects of implementing an atrial fibrillation and flutter pathway on patient at two university-affiliated urban sites. Their primary outcome was the proportion of patients who were correctly started on new anticoagulant medications by the treating emergency physician over an eight month period.
The results are highlighted in our visual abstract. The rates of new anticoagulation on discharge from the emergency department were improved from 48.6% to 70.2%. Median length of stay in the department was also decreased from 262 to 218 minutes. There was also a decreased rate of emergency department revisits for CHF from 13.2% to 2.3%. The authors conclude that AF pathways can reduce system resource utilization and improve patient-oriented outcomes.
The full paper can be found at CJEM online. Co-authors of the study include EM Network members Chris DeWitt, Devin Harris, Robert Stenstrom, Eric Grafstein, Dan Kalla, Julian Marsden, Jim Christenson, and Frank Scheuermeyer.