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
Dr. Alexandra Hamelin is a FRCPC Emergency Medicine resident at the University of Ottawa, Department of Emergency Medicine.
Dr. Rosenberg is an emergency physician at the Ottawa Hospital, associate professor at the University of Ottawa, and Director of the Digital Scholarship and Knowledge Dissemination Program.
Dr. Perry is an Emergency Physician and full Professor in the department of Epidemiology and Community Medicine. He has a special research interest in subarachnoid hemorrhage, TIA and stroke.