title: Get With The Guidelines AFIB: novel quality improvement registry for hospitalized patients with atrial fibrillation.
abstract: BACKGROUND
  Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia. It is a cause of stroke, heart failure, and death. Guideline-based treatment can improve outcomes in AF. Unfortunately, adherence to these guidelines is low. Get With The Guidelines is a hospital-based performance initiative, which has been shown to improve adherence over time. Get With The Guidelines-AFIB is a novel quality improvement registry designed to improve adherence to AF guidelines.
  
  
  RESULTS
  Hospitals will be recruited by regional American Heart Association staff and key stakeholders. Inpatients or observed patients with AF or atrial flutter will be enrolled. Data collected will include demographic, medical history, and clinical characteristics including laboratory values and treatments. Decision support will guide adherence to achievement and quality measures designed to improve adherence to anticoagulation, heart rate control, safe antiarrhythmic drug use, and patient education and follow-up. Increased adherence to guidelines will be facilitated using rapid-cycle quality improvement, site-specific reporting including national and regional benchmarks and hospital recognition for achievement. Primary analyses will include adherence to American Heart Association/American College of Cardiology performance measures and guidelines. Secondary analyses will include processes of care, risk stratification, treatment of special conditions or populations and use of particular treatment techniques.
  
  
  CONCLUSIONS
  AF is common clinical problem with significant morbidity and mortality. Get With The Guidelines-AFIB is a national hospital-based AF quality improvement program designed to increase adherence to evidence-based guidelines for AF.
authors.affiliation: From the Division of Cardiology, Department of Medicine, MetroHealth Campus, Case Western Reserve University, Cleveland, OH (W.R.L.); Duke Center for Atrial Fibrillation, Duke University Medical Center, Durham, NC (J.P.P.); VA Palo Alto Health Care System, Palo Alto, CA (M.P.T.); Department of Medicine, Stanford University School of Medicine, Stanford, CA (M.P.T.); Department of Medicine, University at Buffalo, Buffalo, NY (A.B.C.); Division of Hospital Medicine, Department of Medicine, University of California, San Francisco, CA (M.F.); Department of Emergency Medicine, University of Texas, Southwestern, Dallas, TX (R.E.S.); Department of Clinical Pharmacy, University of Colorado, Aurora, CO (R.L.P.); and Division of Cardiology, Geffen School of Medicine at University of California, Los Angeles, CA (G.C.F.). wlewis@metrohealth.org.
authors.forename: William R
authors.initials: WR
authors.lastname: Lewis
authors.affiliation: From the Division of Cardiology, Department of Medicine, MetroHealth Campus, Case Western Reserve University, Cleveland, OH (W.R.L.); Duke Center for Atrial Fibrillation, Duke University Medical Center, Durham, NC (J.P.P.); VA Palo Alto Health Care System, Palo Alto, CA (M.P.T.); Department of Medicine, Stanford University School of Medicine, Stanford, CA (M.P.T.); Department of Medicine, University at Buffalo, Buffalo, NY (A.B.C.); Division of Hospital Medicine, Department of Medicine, University of California, San Francisco, CA (M.F.); Department of Emergency Medicine, University of Texas, Southwestern, Dallas, TX (R.E.S.); Department of Clinical Pharmacy, University of Colorado, Aurora, CO (R.L.P.); and Division of Cardiology, Geffen School of Medicine at University of California, Los Angeles, CA (G.C.F.).
authors.forename: Jonathan P
authors.initials: JP
authors.lastname: Piccini
authors.affiliation: From the Division of Cardiology, Department of Medicine, MetroHealth Campus, Case Western Reserve University, Cleveland, OH (W.R.L.); Duke Center for Atrial Fibrillation, Duke University Medical Center, Durham, NC (J.P.P.); VA Palo Alto Health Care System, Palo Alto, CA (M.P.T.); Department of Medicine, Stanford University School of Medicine, Stanford, CA (M.P.T.); Department of Medicine, University at Buffalo, Buffalo, NY (A.B.C.); Division of Hospital Medicine, Department of Medicine, University of California, San Francisco, CA (M.F.); Department of Emergency Medicine, University of Texas, Southwestern, Dallas, TX (R.E.S.); Department of Clinical Pharmacy, University of Colorado, Aurora, CO (R.L.P.); and Division of Cardiology, Geffen School of Medicine at University of California, Los Angeles, CA (G.C.F.).
authors.forename: Mintu P
authors.initials: MP
authors.lastname: Turakhia
authors.affiliation: From the Division of Cardiology, Department of Medicine, MetroHealth Campus, Case Western Reserve University, Cleveland, OH (W.R.L.); Duke Center for Atrial Fibrillation, Duke University Medical Center, Durham, NC (J.P.P.); VA Palo Alto Health Care System, Palo Alto, CA (M.P.T.); Department of Medicine, Stanford University School of Medicine, Stanford, CA (M.P.T.); Department of Medicine, University at Buffalo, Buffalo, NY (A.B.C.); Division of Hospital Medicine, Department of Medicine, University of California, San Francisco, CA (M.F.); Department of Emergency Medicine, University of Texas, Southwestern, Dallas, TX (R.E.S.); Department of Clinical Pharmacy, University of Colorado, Aurora, CO (R.L.P.); and Division of Cardiology, Geffen School of Medicine at University of California, Los Angeles, CA (G.C.F.).
authors.forename: Anne B
authors.initials: AB
authors.lastname: Curtis
authors.affiliation: From the Division of Cardiology, Department of Medicine, MetroHealth Campus, Case Western Reserve University, Cleveland, OH (W.R.L.); Duke Center for Atrial Fibrillation, Duke University Medical Center, Durham, NC (J.P.P.); VA Palo Alto Health Care System, Palo Alto, CA (M.P.T.); Department of Medicine, Stanford University School of Medicine, Stanford, CA (M.P.T.); Department of Medicine, University at Buffalo, Buffalo, NY (A.B.C.); Division of Hospital Medicine, Department of Medicine, University of California, San Francisco, CA (M.F.); Department of Emergency Medicine, University of Texas, Southwestern, Dallas, TX (R.E.S.); Department of Clinical Pharmacy, University of Colorado, Aurora, CO (R.L.P.); and Division of Cardiology, Geffen School of Medicine at University of California, Los Angeles, CA (G.C.F.).
authors.forename: Margaret
authors.initials: M
authors.lastname: Fang
authors.affiliation: From the Division of Cardiology, Department of Medicine, MetroHealth Campus, Case Western Reserve University, Cleveland, OH (W.R.L.); Duke Center for Atrial Fibrillation, Duke University Medical Center, Durham, NC (J.P.P.); VA Palo Alto Health Care System, Palo Alto, CA (M.P.T.); Department of Medicine, Stanford University School of Medicine, Stanford, CA (M.P.T.); Department of Medicine, University at Buffalo, Buffalo, NY (A.B.C.); Division of Hospital Medicine, Department of Medicine, University of California, San Francisco, CA (M.F.); Department of Emergency Medicine, University of Texas, Southwestern, Dallas, TX (R.E.S.); Department of Clinical Pharmacy, University of Colorado, Aurora, CO (R.L.P.); and Division of Cardiology, Geffen School of Medicine at University of California, Los Angeles, CA (G.C.F.).
authors.forename: Robert E
authors.initials: RE
authors.lastname: Suter
authors.affiliation: From the Division of Cardiology, Department of Medicine, MetroHealth Campus, Case Western Reserve University, Cleveland, OH (W.R.L.); Duke Center for Atrial Fibrillation, Duke University Medical Center, Durham, NC (J.P.P.); VA Palo Alto Health Care System, Palo Alto, CA (M.P.T.); Department of Medicine, Stanford University School of Medicine, Stanford, CA (M.P.T.); Department of Medicine, University at Buffalo, Buffalo, NY (A.B.C.); Division of Hospital Medicine, Department of Medicine, University of California, San Francisco, CA (M.F.); Department of Emergency Medicine, University of Texas, Southwestern, Dallas, TX (R.E.S.); Department of Clinical Pharmacy, University of Colorado, Aurora, CO (R.L.P.); and Division of Cardiology, Geffen School of Medicine at University of California, Los Angeles, CA (G.C.F.).
authors.forename: Robert L
authors.initials: RL
authors.lastname: Page
authors.affiliation: From the Division of Cardiology, Department of Medicine, MetroHealth Campus, Case Western Reserve University, Cleveland, OH (W.R.L.); Duke Center for Atrial Fibrillation, Duke University Medical Center, Durham, NC (J.P.P.); VA Palo Alto Health Care System, Palo Alto, CA (M.P.T.); Department of Medicine, Stanford University School of Medicine, Stanford, CA (M.P.T.); Department of Medicine, University at Buffalo, Buffalo, NY (A.B.C.); Division of Hospital Medicine, Department of Medicine, University of California, San Francisco, CA (M.F.); Department of Emergency Medicine, University of Texas, Southwestern, Dallas, TX (R.E.S.); Department of Clinical Pharmacy, University of Colorado, Aurora, CO (R.L.P.); and Division of Cardiology, Geffen School of Medicine at University of California, Los Angeles, CA (G.C.F.).
authors.forename: Gregg C
authors.initials: GC
authors.lastname: Fonarow
mesh_terms: D000572:American Heart Association; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use*; D000925:Anticoagulants / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000188:drug therapy / Q000453:epidemiology*; D019985:Benchmarking; D019317:Evidence-Based Medicine; D005500:Follow-Up Studies; D019983:Guideline Adherence; D006760:Hospitalization; D006801:Humans; D017410:Practice Guidelines as Topic; D016730:Program Development; D058996:Quality Improvement; D012042:Registries; D014481:United States
chemical_list: D000889:Anti-Arrhythmia Agents; D000925:Anticoagulants
keywords: antiarrhythmia agents; anticoagulants; atrial fibrillation; atrial flutter; quality assurance, health care