title: Treating the right patient at the right time: an innovative approach to the management of atrial fibrillation.
abstract: The Canadian Cardiovascular Society Access to Care Working Group recently published a series of commentaries on access to cardiovascular care in Canada. These commentaries included proposed minimally acceptable wait times for patients with atrial fibrillation (AF) to be assessed by a cardiologist or an electrophysiologist. To improve access to medical care for the patient with AF, a nurse clinician-based AF clinic was established in the Calgary Health Region (Alberta) in 2005. More than 330 patients had been referred at the time of writing. The time from referral to initial nurse assessment was 38+/-31 days, to physician review and establishment of a management plan was 66+/-49 days and to in-person specialist physician assessment was 80+/-55 days. These wait times are markedly shorter than historical wait times to see an arrhythmia specialist in the Calgary Region. As experience increased, wait times continued to shorten significantly. Preliminary data suggest that early assessment and patient education may reduce emergency department visits and hospitalizations for AF. This experience suggests that a nurse clinician-based AF clinic may provide earlier access to medical care and may improve health outcomes in the long term.
authors.affiliation: Libin Cardiovascular Institute of Alberta and Department of Cardiac Sciences, University of Calgary and Calgary Health Region, Calgary, Alberta. amgillis@ucalgary.ca <amgillis@ucalgary.ca>
authors.forename: Anne M
authors.initials: AM
authors.lastname: Gillis
authors.forename: Laurie
authors.initials: L
authors.lastname: Burland
authors.forename: Beverly
authors.initials: B
authors.lastname: Arnburg
authors.forename: Cheryl
authors.initials: C
authors.lastname: Kmet
authors.forename: P Timothy
authors.initials: PT
authors.lastname: Pollak
authors.forename: Katherine
authors.initials: K
authors.lastname: Kavanagh
authors.forename: George
authors.initials: G
authors.lastname: Veenhuyzen
authors.forename: D George
authors.initials: DG
authors.lastname: Wyse
mesh_terms: D000368:Aged; D000416:Alberta; D001281:Atrial Fibrillation / Q000175:diagnosis* / Q000628:therapy; D002309:Cardiology / Q000592:standards*; D005260:Female; D006297:Health Services Accessibility / Q000592:standards*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D010818:Practice Patterns, Physicians' / Q000592:standards*; D013997:Time Factors; D014218:Triage / Q000592:standards; D014850:Waiting Lists