Establishing a Nurse Led Multidisciplinary Atrial Fibrillation Clinic

Background: Patients with atrial fibrillation (AF) receiving timely, multidisciplinary care (MDC) have reduced morbidity and mortality. AF guideline-indicated MDC incorporates early assessment and patient education with medical therapy to improve health outcomes. Aim: We established a Nurse Led MDC clinic within our tertiary hospital cardiology service to provide early assessment of AF patients, guideline based management and patient education. Goals included seeing patients within six weeks of referral, triaging their on-going care and providing them with a single point of contact within our complex hospital system. Methods: From December 2016 referred patients with a diagnosis of AF have attended a Nurse Led, electrophysiologist-supported clinic for assessment, education and therapy optimisation. Data was collected on the referral source, access times and AF subtype. Patients attend a follow-up visit within three months to assess their management strategy and can contact the AF nurse during business hours. Results: 65 referrals were made to our dedicated service. Referral sources were predominantly the Emergency Department (60%) and General Practitioners (28%). First presentation AF made up 60% of cases. These patients were previously referred as low priority to general cardiology outpatients, waiting 4-6 months for appointments. Through this new model of care, average access times for AF patients was reduced to 4 weeks. Conclusion: A Nurse Led, MDC Clinic for AF patients significantly reduces patient access times preventing delays in assessment, optimisation of therapy and patient education. Further research is needed to evaluate the clinic's impact on patient symptoms, patient satisfaction and hospital readmissions.