The purpose of this survey is:

1.  To understand resourcing for EP programs across the REAL AF network as related to AF ablation volume and outcomes

2.  To provide an evidence and outcomes based benchmark to support our investigators in resourcing their own programs

3.  To understand how EP personnel and resources are utilized

If you have any questions or comments about the survey please email Dr. Amit Thosani (Amit.Thosani@ahn.org)

1.Name(Required.)

2.Organization

3.# of physicians performing AF ablation

4.# of Nurse Practitioners

5.# of PAs

6.How are NPs utilized?

INPATIENT

OUTPATIENT

ASSIST WITH AF PROCEDURE (obtaining access, positioning catheters, etc)

CARDIOVERSION

LOOP RECORDER IMPLANTATION

INDEPENDENT NP LEAD AF CLINIC

Other (please specify)

Not Applicable

7.How are PAs utilized?

INPATIENT

OUTPATIENT

ASSIST WITH AF PROCEDURE (obtaining access, positioning catheters, etc)

CARDIOVERSION

LOOP RECORDER IMPLANTATION

INDEPENDENT NP LEAD AF CLINIC

Other (please specify)

Not Applicable

8.Do you have an outpatient practice manager?

Yes

No

9.Is your (the physician) clinic day:

Full day

Half day

Other (please specify)

10.How many days per week are the physicians in clinic?

Outpatient Clinic Structure (physician):

11.# Of exam rooms per physician

12.# of outpatient nurses per clinic day per physician

13.# of outpatient medical assistants per clinic day per physician

14.# of staff performing preauthorizations per clinic day per physician

15.# of administrative/executive assistants per clinic day per physician

16.# New patients seen by physician in half day of clinic:

17.# Returning patients seen by physician in half day of clinic:

18.How much time is given for new patients (in minutes)

19.How much time is given to returning patients (in minutes)

20.Who performs primary documentation? Check all that apply:

MD

NP

PA

Scribe

Fellow

Medical Student

Other (please specify)

Outpatient Clinic Structure (NP/PA lead clinics)

21.# Of exam rooms per clinician

22.# of outpatient nurses per clinic day per clinician

23.# of outpatient medical assistants per clinic day per clinician

24.# of staff performing preauthorizations per clinic day per clinician

25.# of administrative/executive assistants per clinic day per clinician

26.# New patients seen by a PA/NP in half day of clinic:

27.# Returning patients seen by PA/NP in half day of clinic:

28.Do NPs/PAs see the following:

established patients

new patients

Some procedure follow-up intervals

All procedure follow-up intervals

Other (please specify)

29.Do you have outreach clinics?

Yes

No

30.Who does outreach clinic? Check all that apply.

MD

NP

PA

Other (please specify)

Not Applicable

31.# of outpatient scheduling staff

32.Additional key staff? Check all that apply.

Clinical managers

Nurse navigator

Other (please specify)

None of the above

33.How do you consent patients for procedures? Check all that apply

Discussion in clinic

Signature of consent form prior to day of procedure

Signature of consent form on day of procedure

Multi-level consent process

Other (please specify)

Device Clinic Structure 

34.# of device clinic nurses

35.# of device clinic technicians

36.# of device clinic NP/Pas

37.Do you use any software?

Yes

No

67%