Atrial fibrillation clinical decision aid for emergency medicine providers: An initiative to improve quality healthcare outcomes in adults with new-onset atrial fibrillation.

Background: Atrial fibrillation (AF) affects 6 million Americans with an annual cost of $6 billion and a 30-day readmission rate of 15%.

Methods: We conducted a quality improvement project using pretest-posttest analysis to determine the effects of an AF clinical decision aid for Emergency Medicine providers on quality measures for patients with new-onset AF at a tertiary care facility. Outcomes included readmission rates, documentation of thromboembolic risk (CHADS-VASc), bleeding risk (HAS-BLED), incidence of anticoagulation (AC) patient education, and prescription of AC. Data was obtained via chart review. Standard statistical techniques were used.

Results: 225 patients (mean age 67.5 years, 66% male, 76% Caucasian) were studied. The 30-day readmission rate for symptomatic AF decreased from 17% to 1.3% (p = 0.01). There was no difference in provider documentation, incidence of AC patient education, or prescription of AC following implementation.

Conclusions: Utilization of a clinical decision aid significantly reduces 30-day readmission for symptomatic AF.