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Augmenting Atrial Fibrillation Care After an Emergency Department Visit: Implementing Telephone Practice
Danielle Hart1, Wilma M Hopman, Sharlene Hammond
1Heart Rhythm Service, Queen's University, Kingston, Ontario, Canada (Mss Hart and Hammond and Dr Redfearn); and Kingston General Health Research Institute (KGHRI), Kingston Health Sciences Centre, Kingston, Ontario, Canada (Ms Hopman).
Background:
Between 2010 and 2012, the Heart Rhythm team in a tertiary care hospital completed a retrospective study that found that atrial fibrillation (AF) care can be episodic and heavily reliant on hospital resources, particularly the emergency department (ED).
Problem:
Patients who attend the ED with AF are at high risk of hospital admission.
Approach:
A nurse practitioner (NP) was added to the Heart Rhythm team to create a program to improve AF care after an ED visit. Telephone practice was one of the many processes created.
Outcomes:
Findings revealed that 37 of 90 patients presented to the ED with AF prior to telephone contact and 7 of 90 patients did so post-telephone contact (P < .001).
Conclusion:
Telephone practice led by an NP provides an opportunity to improve assessment and management of patient with AF and offers a promising cost-effective method to reduce ED visits in the AF patient population.
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