American College of Cardiology
The ACC offers numerous quality initiatives to help ensure high-quality patient care, including the Anticoagulation Initiative in patients with AF. The ACC also offers several clinical toolkits and assessment tools to assist clinicians.
Online Resources
American Heart Association and Heart Rhythm Society
Get With the Guidelines® AFib Program
Get With The Guidelines-AFib is a hospital-based quality improvement initiative developed by the AHA and the HRS to help improve adherence to evidence-based AF treatment guidelines. The program offers tools and resources to help improve processes and maximize effectiveness.
Centers for Medicare & Medicaid Services (CMS) - Atrial Fibrillation and Anticoagulation
The CMS has several quality measures specific to atrial fibrillation (AF) and/or anticoagulation.
The Joint Commission
Specifications Manual for Joint Commission National Quality Measures (v2018A). Stroke (STK)
The Joint Commission, in collaboration with the American Heart Association (AHA), American Stroke Association (ASA), and the Brain Attack Coalition (BAC) has developed a set of 8 quality measures associated with anticoagulation use in stroke for use by Disease-Specific Care-Certified Primary Stroke Centers; data collection for all 8 stroke measures is required for Primary and Comprehensive Stroke Center Certification. STK-3 is the measure specific to anticoagulation use in patients with atrial fibrillation (AF) or atrial flutter. The Joint Commission also offers an AF certification.
National Quality Forum (please enter atrial fibrillation into the search bar)
The NQF establishes and endorses evidence-based, consensus-approved standards and measures to help improve the quality and safety of patient care. Atrial Fibrillation and Atrial Flutter: Chronic Anticoagulation Therapy (Measure 1525) is currently being updated.
Society of Hospital Medicine (SHM): Hospital-Based Quality Improvement in Stroke Prevention for Patients with Non-Valvular Atrial Fibrillation: A Society of Hospital Medicine Program Implementation Guide (2014)
This guide to implementation of a hospital-based, interdisciplinary quality improvement initiative for reduction of stroke risk in patients with NVAF includes a list of metrics and information to help improve the transition of care to the outpatient setting.
US Department of Health and Human Services, Office of Disease Prevention and Health Promotion (ODPHP): National Action Plan for ADE Prevention – Anticoagulants (ODPHP 2014)
The US DHHS published their national action plan for the prevention of anticoagulant-associated adverse drug events (ADEs), particularly bleeding, in 2014. The plan calls for safer use of anticoagulants based on proper assessment of stroke and bleeding risks and alignment with evidence-based treatment guidelines, coordination of care between various inpatient and outpatient settings to help ensure continuity of care, appropriate patient education on the risks and benefits of anticoagulants, improved surveillance of real-world bleeding complications attributed to anticoagulants, and incorporation of health care quality measures specific to anticoagulation safety.