Abstract:
Background:
Atrial fibrillation (AF) is one of the most common arrhythmias encountered in acute and inpatient settings within NHS Lothian. Despite the availability of local guidelines, variability in AF management and lack of confidence among junior doctors remain challenges, particularly in acute presentations. Clear, up-to-date, and user-friendly guidance is essential to support safe and effective decision-making.
Aim:
This quality improvement (QI) project aimed to update the existing NHS Lothian AF pathway to improve clarity, usability, and clinical relevance, with a specific focus on supporting junior doctors in the assessment and management of AF.
Methods:
A review of the current NHS Lothian AF guideline was undertaken and compared against up-to-date national guidance and evidence-based practice. Key areas of ambiguity and
complexity were identified through informal feedback from junior doctors. The pathway was revised to simplify decision-making, improve flow, and emphasise practical management steps, including rate versus rhythm control, anticoagulation considerations, and escalation criteria.
Results:
The updated AF pathway provides a clearer, more structured approach to AF management, with improved accessibility and clinical applicability. Feedback from junior doctors
suggested increased confidence in managing AF, particularly in acute and on-call settings. The revised pathway aims to promote consistent, guideline-aligned care across NHS Lothian.
Conclusion:
Updating the NHS Lothian AF pathway as a QI initiative has improved the usability of local guidance and supported junior doctors in managing AF more confidently and safely. Ongoing education and feedback will be essential to sustain improvements and further optimise AF care within the organisation.
Biography:
Dr. Nur Balzureen Suhaimi is a medical doctor originally from Malaysia and a graduate of the University of Aberdeen. She is currently working as an FY2 Resident Doctor in NHS Lothian, based in Edinburgh. She has a strong interest in clinical research, quality improvement, and medical education, alongside a growing passion for cardiology. Dr. Suhaimi is particularly motivated to improve guideline accessibility and junior doctor confidence in managing common acute medical conditions through practical, clinically focused quality improvement projects.
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