AF-Express Clinic in a Tertiary, Metropolitan Hospital Reduces Emergency Department Re-Admissions

Abstract

Background: The total number of Atrial Fibrillation (AF) hospitalisations in Australia continues to increase more than for any other cardiovascular condition. Methods: The AF-Express clinic (AFX) uses hospital data systems to automatically identify patients who have presented to Emergency Department (ED) with AF. The nurse-led clinic aim is to make early review available in less than 5 working days. We aim for 100% capture. Clinic care is targeted toward guaranteeing basic investigations and delivery of the AF care set. Results: Data show an increase in AFX episodes, and significant downward trend in the number of ED episodes, explaining a preliminary finding of ∼16% downward trend of all AF episodes. Supporting this evidence is the small number who re-present (1.3%) after being seen in AFX as opposed to 9.3% who re-present who have not previously been seen in AFX (see Table 1).Table 1EpisodeRe-admissionsED117 (21.2%)Previously seen in AFX1.3%Not seen in AFX9.3%Not seen in AFX who re-present ≥2 and ≤6 times2.5% Open table in a new tab Conclusions: There are early signs that the AFX, by ensuring consistent delivery of care, can reduce ED re-admissions. Ongoing evaluation of this cohort including guideline and treatment gaps are needed to influence care delivery. Using informatics system developments, AFX will serve as a template for development of other informatics-based low cost, scalable, nurse-led healthcare delivery programs.