1. Y&H Atrial Fibrillation Stroke Prevention Programme
GP Practice Guide
UKXAR Date of Preparation – June 2017

2. We are preventing strokes.
We are identifying patients who have AF and getting them on the AF register. We are prescribing an anticoagulant to as many patients with AF with a CHADS2VA2Sc > 2 as possible.

3. We are using QI to prevent strokes
There is no ‘one best way’ to find more AF patients and anticoagulate them. Each practice must find its own path to success. QI is Quality Improvement. It’s a method not an outcome. The process is simple. We are using plan-do-study-act cycles to test what works and tracking the impact on patient care over time.

4. Step 1
If you know what a PDSA cycle is, well done, you can skip this step.
If you don’t know what a PDSA cycle is you need to learn.
Options are:
The Improvement Academy’s on-line learning:
The RCGP’s QI Hub:
Asking a colleague who has done a QI project using PDSA cycles.

5. Step 2 Know your numbers. These are how we will measure improvement.
Use SystmOne/Emis to get these numbers. You will need to do this every week for 24 weeks.
Number of patients on the practice’s AF register.
Number of patients with AF with a CHADS2VA2Sc > 2 who are prescribed an anticoagulant.
Both theses numbers are part of QOF AF001 and AF007

6. Step 3
If you are already signed up to the SeeData LIFE QI system you can skip this step. If you are not signed up already at least one person from the practice needs to sign up here: It should be the person who will record your PDSA cycles and submit your measures of improvement. You can get help with this from Ruth Pitman-Jones

7. Step 4
Order the Mobile-ECG Device(s) you want to start with. You can have Watch-BP or Alivecor Kardia or both. Start with the lowest number you can to see what works for you. Use this form and send it to You can order more as you complete your PDSA cycles on the LIFE QI system.

8. Think about what small thing you will try first
Step 5
Think about what small thing you will try first

9. Use the PDSA method to plan
Step 6
Use the PDSA method to plan
Find patients who have AF but are not on AF register. The AF register will get bigger. Use the Alivecor Device to detect possible AF. (change idea) How can we make this work? Plan:

10. Step 7
Log on to the SeeData LIFE system
Add your numbers to the charts tab.
Add your fist Plan in the PDSA tab.
Once this is complete we will make an appointment for you to meet your QI facilitator (if you need one) and give you your starter pack.

11. In your starter pack You’ll find:
Your initial allocation of AliveCor Kardia or Watch BP devices.
Anticoagulate with Jack postcards with pharmacy sign-post.
Your allocation of AF Cardex – Top Tips aide memoires.
A New Medicines Service support pack for community pharmacy.