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Quality Improvement Topics
3D Mapping for PVI – Geometry, Image Integration and Incorporation of Contact Force Into Work Flow
Journal Articles: Catheter ablation of atrial fibrillation has evolved enormously thanks to rapid improvement of modern mapping technologies, progress in catheter development and current possibilities for reduction of radiation exposure. Pulmonary vein isolation is thereby the cornerstone in this interventional treatment. Increased precision of catheter localization by modern three-dimensional mapping systems, faster and better processing of local electrograms and their immediate color-based visualization make it possible to treat even challenging arrhythmias very effectively. The commonly used three-dimensional mapping systems CARTO 3 (Biosense Webster, Irvine, Ca.) and Ensite Precision (St. Jude Medical, St. Paul, Min) differ in construction and principles of the underlying mapping technology. In this review article, we aim to emphasize the most important aspects of possibilities that make both systems so valuable for interventional treatment of atrial fibrillation. We present a modern workflow, that unites three-dimensional LA mapping with collecting relevant local information, image integration for refining the map and beneficial use of contact force based ablation approach.
Designing an Efficient and Quality-focused Integrated Atrial Fibrillation Care Center
Best Practices: Best practices for developing an efficient and quality-focused AF ablation program as part of a larger AF center of excellence, highlighting the experience of a single center and demonstrating how the same principles were adopted to implement a similar program at another institution.
Patient in Room to Physician in Room
Data/Registries: This sample report shows performance over time of patient in room compared to physician in room and patient in room access compared to when the patient arrives in the lab.
Quality Tracking Tool – Lab Efficiency
Data/Registries: This spreadsheet can be used to track procedure times in the EP lab. Once compiled into a database, reporting can be provided to stakeholders each month with physician times.
Business Plan Electrophysiology Laboratory – Staffing/Volume Increase
Business Plans: Business Plan Electrophysiology Laboratory – Staffing/Volume Increase
Sample Electrophysiology Lab Business Plan Presentation to Admin
Business Plans: Extensive sample business plan presentation to utilize when advocating for an EP lab to administrative stakeholders. Includes AFib statistics, forecasted ablation growth, patient benefits, leadership strategy, and more.
Tamponade Checklist
Checklists: Helpful checklist for the care team when treating a patient with cardiac tamponade.
Cardiac Electrophysiology Preoperative Form/Checklist
Checklists: This Preoperative Checklist can be used by teams for all patients coming to the EP lab.
Atrial Fibrillation: Diagnosis and Management
Guidelines/Clinical Documents: The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using their service. It is not mandatory to apply the recommendations, and the guideline does not override the responsibility to make decisions appropriate to the circumstances of the individual, in consultation with them and their families and carers or guardian.
All problems (adverse events) related to a medicine or medical device used for treatment or in a procedure should be reported to the Medicines and Healthcare products Regulatory Agency using the Yellow Card Scheme.
Local commissioners and providers of healthcare have a responsibility to enable the guideline to be applied when individual professionals and people using services wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with complying with those duties.
Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.