Improving documentation of DVLA driving restrictions in emergency electrophysiology

Effective communication of the United Kingdom Driver and Vehicle Licensing Agency (DVLA) driving restrictions is vital for safeguarding patients and the public after emergency electrophysiology (EP) procedures. Observations within our tertiary centre indicated considerable variation in how these restrictions were documented, prompting a quality improvement project (QIP) to review current performance and introduce strategies to enhance consistency.

To evaluate the documentation of DVLA driving guidance for emergency EP patients - typically clerked and discharged by rotating resident doctors - and to assess whether targeted interventions could raise documentation standard to levels routinely achieved in clinical nurse specialist (CNS)-led elective EWP pathways.

The initial audit cycle reviewed 25 emergency EP cases managed between January and March 2025. The documentation of driving status, DVLA guidance within the electronic Patient Information and Clinical Summary (PICS) system, and DVLA advice included in discharge summaries were assessed. A comparison cohort of 25 elective EP patients was also analysed. Notably, the elective EP admissions and discharges were led by Cardiology CNS. Based on initial findings, an intervention consisting of focused teaching for resident doctors and placement of visual reminders on the ward was implemented. A second audit cycle reviewed 27 emergency EP patients treated between August and November 2025.

During the first cycle, documentation rates in emergency EP patients were low: driving status was recorded in 36% of cases, DVLA guidance was documented in 27%, and DVLA guidance was written in 18% of discharge letters. Elective cases demonstrated far superior rates (86% for both DLVA guidance documentation on PICs and discharge documentation), reflecting the structured and specialised CNS-led workflow. Following the intervention, documentation among emergency EP patients improved substantially, with driving status recorded in 55.6%, DVLA information added to PICS in 70.3%, and discharge letter advice documented in 54.2%.

The comparison between emergency and elective EP patients highlights the positive influence of CNS-led processes in documentation quality. Introducing targeted education and simple visual prompts led to meaningful improvements in documentation by resident doctors carding for emergency EP patients These findings reinforced that low-cost, practical measures can significantly strengthen communication of driving restrictions and enhance post-procedural patient safety. Continued efforts will focus on embedding these improvements and supporting wider standardisation across EP services.