Get With The Guidelines®-AFIB
Bronze Achievement Award Application
Improvement in the treatment of atrial fibrillation
by implementation of Get With The Guidelines® AFIB
Hospital Name (as it appears on the certificate)
Full Address (Street, City, State, Zip)
Submitted by: Please list first and last names, credentials, and email address)
For patients with Atrial Fibrillation (ICD = 427.31) or Atrial Flutter (ICD = 427.32)
Background: Programs for in-hospital initiation of American Heart Association/American College of
Cardiology guideline-recommended treatment and prevention therapies have been associated with improved
treatment rates, and improved clinical outcomes. With the aim of improving treatment for patients
hospitalized with atrial fibrillation we implemented the AHA’s Get With Guidelines ®-AFIB program.
Method: Baseline date is mm/dd/yyyy as defined on the Community Page of the PMT .
Quality Improvement Strategies: Please check ALL that apply:
☐Physician Champion
☐Specific person or department assigned?
☐Multidisciplinary Team
☐Metrics in Performance Objectives?
☐Team Leader
☐Tests of Change (Ex. PDSA, PDCA, etc.)
☐Standing Order Sets
☐Tracer Methodology
☐Pre-printed Discharge Forms
☐Leadership (C Suite) Support
☐System Reminder
☐Regular meetings of Multidisciplinary Team
(chart flag, automated message trigger, task list, etc.)
☐QII reporting to hospital committees
☐Staff Education
☐QII reporting to hospital executive/board committees
☐Physician Education
☐QII goals incorporated into hospital performance goals
☐Patient Education
☐“Discharge Time Out” (TJC safety recommendation)
☐Multidisciplinary Rounds
☐Other: ____________________________________
☐Staff Accountability
Please check all that apply: Our hospital is entering data into the PMT:
☐ Concurrently
☐ Retrospectively (after patient is discharged)
☐ Via uploads
December 2014
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Post-Intervention
Time of Compliance (must be in full calendar quarters only)
mm/dd/yyyy-mm/dd/yyyy
Total number of atrial fibrillation or atrial flutter hospital discharges
during the post-intervention period.
<number>
Number of patients entered into the PMT during this post-intervention
Period. For low volume hospitals, 30 patient minimum per reporting
period or the Equivalent of 12 months of patients are required.
<number>
If the two above numbers are different, please explain your sampling
Methodology. Minimum requirement for sampling will be
The Joint Commission sampling methodology.
Explain if above numbers different>
Results: Implementation of Get With The Guidelines-AFIB showed treatment rates of pre-and postintervention as indicated by the results in the charts below.
You must provide the numerator (N) and denominator (D) as well as percentage for the following items.
The percentage must be at a minimum of 84.55% and rounded up to the first decimal (84.6%) as this
conforms to PMT percentage reporting.
The grid below reflects the AFIB Achievement Measure Group:
Achievement Measures
For guideline eligible patients without contraindications
(Listed as titled in the GWTG Patient Management Tool)
ACEI/ARB at discharge for LVSD: Percent of patients with left ventricular
systolic dysfunction (LVSD) and without both angiotensin converting enzyme
inhibitor (ACEI) and angiotensin receptor blocker (ARB) contraindications who
are prescribed an ACEI or ARB at hospital discharge. For purposes of this
measure, LVSD is defined as chart documentation of a left ventricular ejection
fraction (LVEF) less than 40% or a narrative description of left ventricular function
(LVF) consistent with moderate or severe systolic dysfunction.
Preintervention
Postintervention
N/D
%
N/D
%
N/D
%
N/D
%
N/D
%
N/D
%
N/D
%
N/D
%
Assessment of thromboembolic risk factors:
Please check the appropriate box.
☐Percent of patients with nonvalvular atrial fibrillation or atrial flutter in whom
assessment of thromboembolic risk factors using the CHADS2 risk criteria has
been documented.
OR
☐Percent of patients with nonvalvular atrial fibrillation or atrial flutter in whom
assessment of thromboembolic risk factors using the CHA2DS2-VASc risk criteria
has been documented.
Beta blocker at discharge: Percent of patients with left ventricular systolic
dysfunction (LVSD) prescribed a beta blocker at hospital discharge.
Discharged on FDA-approved anticoagulation therapy:
Please check the appropriate box.
☐Percent of patients discharged on warfarin or other anticoagulant drug that is
FDA approved for the prevention of thromboembolism for all patients with
nonvalvular atrial fibrillation or atrial flutter at high risk for thromboembolism,
according to CHADS2 risk stratification.
OR
December 2014
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☐Percent of patients discharged on warfarin or other anticoagulant drug that is
FDA approved for the prevention of thromboembolism for all patients with
nonvalvular atrial fibrillation or atrial flutter at high risk for thromboembolism,
according to CHA2DS2-VASc risk stratification.
PT/INR planned follow-up (for patients discharged on Warfarin): Percent of
patients discharged on warfarin who have PT/INR follow-up planned prior to
hospital discharge, including documentation of a date of INR, test planned post
discharge and type of INR monitoring planned (Home Monitoring, Anticoagulation
Clinic, or Physician)
N/D
%
N/D
%
Statin at discharge in AF patients with CAD, CVA/TIA or PVD: Percent of
patients with either CAD, CVA/TIA, PVD or diabetes who were prescribed a statin
at hospital discharge.
N/D
%
N/D
%
Optional
Reporting**
Pre-intervention (Baseline)
Post-intervention
Composite score
Total Patients, N/D (composite score %)
Total Patients, N/D (composite score %)
Defect Free score
Defect-Free patients/Total Patients (%)
Defect-Free patients/Total Patients (%)
**Composite and Defect Free Measures: Indicates a hospital’s performance over all patients for selected elements of
care.
a) The composite performance is the mean % of eligible measures received by each patient. This average is
calculated by summing the number of times patients received selected interventions and dividing that by the total
number of interventions for which these patients were eligible.
b) Defect free care measure: Shows the percentage of patients who received all eligible interventions, i.e.
patients who received all the appropriate care, where 100% equals defect-free.
December 2014
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