Question and Methods: Using a stepped wedge cluster randomized trial, does implementation of the CAEP Best Practice Checklist for acute atrial fibrillation and atrial flutter improve patient care by reducing ED length of stay?
Findings: The intervention reduced ED length of stay by 20.9% increased the use of rhythm control, and increased anticoagulation at discharge in those at risk of stroke, with no change in adverse events or stroke at 30 days.
Limitations: There was no telephone follow-up at 30 days or access to province-wide databases outside of Ontario, which could have potentially missed some 30-day adverse outcomes.
Interpretation: There were observed definite improvements in care, however there remains further opportunities for better compliance with guidelines with local implementation efforts in some centers.
JC Supervisor: Dr. Jeff Perry