Methodology: 4/5
Usefulness: 5/5

Stiell IG, et al. Can J Cardiol. 2021 Oct;37(10):1569-1577.

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. 

By: Dr. Alexandra Hamelin

JC Supervisor: Dr. Jeff Perry