A new efficient and integrated pathway for patient evaluation prior to atrial fibrillation ablation
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A new efficient and integrated pathway for patient evaluation prior to atrial fibrillation ablation. / Verhaert, Dominique V. M.; Linz, Dominik; Wassink, Geert F.; Weijs, Bob; Philippens, Suzanne; Luermans, Justin G. L. M.; Westra, Sjoerd W.; Schotten, Ulrich; Vernooy, Kevin; den Uijl, Dennis W.
In: European Journal of Cardiovascular Nursing, Vol. 22, No. 5, 2023, p. 498–505.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - A new efficient and integrated pathway for patient evaluation prior to atrial fibrillation ablation
AU - Verhaert, Dominique V. M.
AU - Linz, Dominik
AU - Wassink, Geert F.
AU - Weijs, Bob
AU - Philippens, Suzanne
AU - Luermans, Justin G. L. M.
AU - Westra, Sjoerd W.
AU - Schotten, Ulrich
AU - Vernooy, Kevin
AU - den Uijl, Dennis W.
PY - 2023
Y1 - 2023
N2 - Aims In this quality improvement project, a care pathway for patients considered for atrial fibrillation (AF) ablation was optimized with the goals to improve the patient journey and simultaneously integrate prospective data collection into the clinical process. Methods and results The Lean Six Sigma approach was used to map the pre-existing process, identify constraints, and formulate countermeasures. The percentage of patients going through the full pre-ablation preparation that eventually underwent AF ablation, number of hospital visits and consultations, pathway compliance, and completeness of scientific data were measured before and after pathway optimization. Constraints in the process were (i) lack of standardized processes, (ii) inefficient use of resources, (iii) lack of multidisciplinary integration, (iv) lack of research integration, and (v) suboptimal communication. The impact of the corresponding countermeasures (defining a uniform process, incorporating 'go/no-go' moment, introducing a 'one-stop-shop', integrating prospective data collection, and improving communication) was studied for 33 patients before and 26 patients after pathway optimization. After optimization, the percentage of patients receiving a full pre-ablation preparation that eventually underwent AF ablation increased from 59% to 94% (P < 0.01). Fewer hospital visits (3.2 +/- 1.2 vs. 2.3 +/- 0.8, P = 0.01) and electrophysiologist consultations (1.8 +/- 0.7 vs. 1.0 +/- 0.3, P < 0.01) were required after pathway optimization. Pathway compliance and complete collection of scientific data increased significantly (3% vs. 73%, P < 0.01 and 15% vs. 73%, P < 0.01, respectively). Conclusion The optimization project resulted in a more efficient evaluation of patients considered for AF ablation. The new more efficient process includes prospective data collection and facilitates easy conduct of research studies focused on improvements of patient outcomes.
AB - Aims In this quality improvement project, a care pathway for patients considered for atrial fibrillation (AF) ablation was optimized with the goals to improve the patient journey and simultaneously integrate prospective data collection into the clinical process. Methods and results The Lean Six Sigma approach was used to map the pre-existing process, identify constraints, and formulate countermeasures. The percentage of patients going through the full pre-ablation preparation that eventually underwent AF ablation, number of hospital visits and consultations, pathway compliance, and completeness of scientific data were measured before and after pathway optimization. Constraints in the process were (i) lack of standardized processes, (ii) inefficient use of resources, (iii) lack of multidisciplinary integration, (iv) lack of research integration, and (v) suboptimal communication. The impact of the corresponding countermeasures (defining a uniform process, incorporating 'go/no-go' moment, introducing a 'one-stop-shop', integrating prospective data collection, and improving communication) was studied for 33 patients before and 26 patients after pathway optimization. After optimization, the percentage of patients receiving a full pre-ablation preparation that eventually underwent AF ablation increased from 59% to 94% (P < 0.01). Fewer hospital visits (3.2 +/- 1.2 vs. 2.3 +/- 0.8, P = 0.01) and electrophysiologist consultations (1.8 +/- 0.7 vs. 1.0 +/- 0.3, P < 0.01) were required after pathway optimization. Pathway compliance and complete collection of scientific data increased significantly (3% vs. 73%, P < 0.01 and 15% vs. 73%, P < 0.01, respectively). Conclusion The optimization project resulted in a more efficient evaluation of patients considered for AF ablation. The new more efficient process includes prospective data collection and facilitates easy conduct of research studies focused on improvements of patient outcomes.
KW - Atrial fibrillation
KW - Catheter ablation
KW - Pathway optimization
KW - Lean Six Sigma
KW - Care pathway
KW - Research integration
KW - CLINICAL CARE
KW - METHODOLOGIES
KW - MANAGEMENT
U2 - 10.1093/eurjcn/zvac095
DO - 10.1093/eurjcn/zvac095
M3 - Journal article
C2 - 36218087
VL - 22
SP - 498
EP - 505
JO - European Journal of Cardiovascular Nursing
JF - European Journal of Cardiovascular Nursing
SN - 1474-5151
IS - 5
ER -
ID: 325376093