Get with the Guidelines -AFIB

Get With The Guidelines®-AFIB Bronze Achievement Award Application

Improvement in the treatment of atrial fibrillation by implementation of Get With The Guidelines® AFIB

Hospital Name (as it appears on the certificate)

Full Address (Street, City, State, Zip)

Submitted by: Please list first and last names, credentials, and email address)

For patients with Atrial Fibrillation (ICD = 427.31) or Atrial Flutter (ICD = 427.32)

Background: Programs for in-hospital initiation of American Heart Association/American College of Cardiology guideline-recommended treatment and prevention therapies have been associated with improved treatment rates, and improved clinical outcomes. With the aim of improving treatment for patients hospitalized with atrial fibrillation we implemented the AHA’s Get With Guidelines®-AFIB program.

Method: Baseline date is mm/dd/yyyy as defined on the Community Page of the PMT.

Quality Improvement Strategies: Please check ALL that apply:

☐Physician Champion ☐Specific person or department assigned? ☐Multidisciplinary Team ☐Metrics in Performance Objectives? ☐Team Leader ☐Tests of Change (Ex. PDSA, PDCA, etc.) ☐Standing Order Sets ☐Tracer Methodology ☐Pre-printed Discharge Forms ☐Leadership (C Suite) Support ☐System Reminder ☐Regular meetings of Multidisciplinary Team (chart flag, automated message trigger, task list, etc.) ☐QII reporting to hospital committees ☐Staff Education ☐QII reporting to hospital executive/board committees ☐Physician Education ☐QII goals incorporated into hospital performance goals ☐Patient Education ☐“Discharge Time Out” (TJC safety recommendation) ☐Multidisciplinary Rounds ☐Other: ______

1 December 2014 ☐Staff Accountability

Please check all that apply: Our hospital is entering data into the PMT: ☐ Concurrently ☐ Retrospectively (after patient is discharged) ☐ Via uploads

2 Post-Intervention Time of Compliance (must be in full calendar quarters only) mm/dd/yyyy-mm/dd/yyyy

Total number of atrial fibrillation or atrial flutter hospital discharges during the post-intervention period.

Number of patients entered into the PMT during this post-intervention Period. For low volume hospitals, 30 patient minimum per reporting period or the Equivalent of 12 months of patients are required.

If the two above numbers are different, please explain your sampling Methodology. Minimum requirement for sampling will be Explain if above numbers different> The Joint Commission sampling methodology.

Results: Implementation of Get With The Guidelines-AFIB showed treatment rates of pre-and post- intervention as indicated by the results in the charts below.

You must provide the numerator (N) and denominator (D) as well as percentage for the following items. The percentage must be at a minimum of 84.55% and rounded up to the first decimal (84.6%) as this conforms to PMT percentage reporting.

The grid below reflects the AFIB Achievement Measure Group:

Achievement Measures Pre- Post- For guideline eligible patients without contraindications intervention intervention (Listed as titled in the GWTG Patient Management Tool) ACEI/ARB at discharge for LVSD: Percent of patients with left ventricular systolic dysfunction (LVSD) and without both angiotensin converting enzyme inhibitor (ACEI) and angiotensin receptor blocker (ARB) contraindications who are prescribed an ACEI or N/D N/D ARB at hospital discharge. For purposes of this measure, LVSD is defined as chart documentation of a left ventricular ejection fraction (LVEF) less than 40% or a narrative % % description of left ventricular function (LVF) consistent with moderate or severe systolic dysfunction.

Assessment of thromboembolic risk factors: Please check the appropriate box.

☐Percent of patients with nonvalvular atrial fibrillation or atrial flutter in whom assessment of thromboembolic risk factors using the CHADS2 risk criteria has been N/D N/D documented. % % OR

☐Percent of patients with nonvalvular atrial fibrillation or atrial flutter in whom assessment of thromboembolic risk factors using the CHA2DS2-VASc risk criteria has been documented.

Beta blocker at discharge: Percent of patients with left ventricular systolic dysfunction N/D N/D (LVSD) prescribed a beta blocker at hospital discharge. % % Discharged on FDA-approved anticoagulation therapy: N/D N/D Please check the appropriate box. % % ☐Percent of patients discharged on warfarin or other anticoagulant drug that is FDA approved for the prevention of thromboembolism for all patients with nonvalvular atrial fibrillation or atrial flutter at high risk for thromboembolism, according to CHADS2 risk stratification.

3 December 2014 ☐Percent of patients discharged on warfarin or other anticoagulant drug that is FDA approved for the prevention of thromboembolism for all patients with nonvalvular atrial fibrillation or atrial flutter at high risk for thromboembolism, according to CHA2DS2- VASc risk stratification.

PT/INR planned follow-up (for patients discharged on Warfarin): Percent of patients discharged on warfarin who have PT/INR follow-up planned prior to hospital discharge, N/D N/D including documentation of a date of INR, test planned post discharge and type of INR % % monitoring planned (Home Monitoring, Anticoagulation Clinic, or Physician)

Statin at discharge in AF patients with CAD, CVA/TIA or PVD: Percent of patients with either CAD, CVA/TIA, PVD or diabetes who were prescribed a statin at hospital N/D N/D discharge. % %

Optional Pre-intervention (Baseline) Post-intervention Reporting**

Composite score Total Patients, N/D (composite score %) Total Patients, N/D (composite score %)

Defect Free score Defect-Free patients/Total Patients (%) Defect-Free patients/Total Patients (%)

**Composite and Defect Free Measures: Indicates a hospital’s performance over all patients for selected elements of care. a) The composite performance is the mean % of eligible measures received by each patient. This average is calculated by summing the number of times patients received selected interventions and dividing that by the total number of interventions for which these patients were eligible.

b) Defect free care measure: Shows the percentage of patients who received all eligible interventions, i.e. patients who received all the appropriate care, where 100% equals defect-free.