Improving Emergency Department Prescribing of Anticoagulation for Atrial Fibrillation Through an Iterative Quality Improvement Process

Finn Brokenshire; Kaleb Addy; John W. Pickering; Ibrahim Al-Busaidi; Martin Than; Richard Troughton; Laura R. Joyce

doi:10.1111/1742-6723.70097

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Improving Emergency Department Prescribing of Anticoagulation for Atrial Fibrillation Through an Iterative Quality Improvement Process

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Improving Emergency Department Prescribing of Anticoagulation for Atrial Fibrillation Through an Iterative Quality Improvement Process

Finn Brokenshire, Kaleb Addy, John W. Pickering, Ibrahim Al-Busaidi, Martin Than, Richard Troughton and Laura R. Joyce

Emergency medicine Australasia, Vol.37(4), e70097

11/07/2025

DOI: https://doi.org/10.1111/1742-6723.70097

Handle:

https://hdl.handle.net/10523/47021

Abstract

atrial fibrillation (AF)

clinical pathway

emergency department

Objective: To assess the impact of two iterations of an emergency department (ED) atrial fibrillation (AF) pathway on anticoagulant prescribing. Methods: Two quality improvement projects gave targeted anticoagulation guidance for AF. Anticoagulation prescription rates and related adverse events were monitored across four cohorts over 9 years (2014–2023). Results: A total of 1425 patients were included. The proportion of patients discharged from ED on anticoagulation increased from 45% to 83%. Sixty-day thromboembolic events, bleeding events and all-cause mortality were unchanged. Conclusions: Targeted anticoagulation guidance within an AF pathway improved adherence without raising adverse events.

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Record Identifier: 9926755652301891
Title: Improving Emergency Department Prescribing of Anticoagulation for Atrial Fibrillation Through an Iterative Quality Improvement Process
Creators: Finn Brokenshire
Kaleb Addy
John W. Pickering
Ibrahim Al-Busaidi
Martin Than
Richard Troughton
Laura R. Joyce
Publication Details: Emergency medicine Australasia, Vol.37(4), e70097
Academic Unit: Surgery and Critical Care (UOC); Medicine (UOC); Primary Health Care (UOC)
Publisher: Wiley
Grant note: Maurice and Phyllis Paykel Trust; Canterbury Medical Research Foundation
Date published ; e-published: 11/07/2025
Copyright: Copyright © The Author(s) 2025. This work was first published in Emergency Medicine Australasia (Wiley). This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial use, distribution and reproduction in any medium, provided the original work is properly attributed to the creator(s) and the source, is not altered, transformed, or built upon in any way, and a link to the Creative Commons license is provided.
Language: English
Resource Type ; Subtype: Journal article