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Anticoagulation
Objectives
Anticoagulation therapy is a complex and labor-intensive intervention for which success depends upon correct dosing decisions, close attention to many details, and good communication among all parties involved. In a recent study anticoagulants were responsible for 121 of the 1523 adverse drug events, a third of which were considered preventable1. In a recent TMIT survey conducted by the Iowa Healthcare Collaborative (IHC), 116 Iowa hospitals rated anticoagulation as an extremely relevant problem within the state.
Recognizing this problem, IHC has produced an Anticoagulation Toolkit for health care providers. The objective of this initiative is to ensure effective and safe long-term anticoagulation therapy in all care settings in Iowa. IHC hopes this resource will offer more information on the issue as well as practical solutions.
Project Team
The project team includes health care providers representing the following participating facilities:
- Allen Memorial Hospital Anticoagulation Clinic, Waterloo, IA
- Central Community Hospital, Elkader, IA
- Greater Cedar Rapids Anticoagulation Clinic, Cedar Rapids, IA
- Great River Medical Center, Burlington, IA
- Guttenberg Hospital Anticoagulation Therapy Program, Guttenberg, IA
- Madison County Anticoagulation Management Clinic, Winterset, IA
- Mercy Medical Center - North Iowa, Mason City, IA
- University of Iowa Hospitals and Clinics, Iowa City, IA
- Veterans Administration Medical Center of Central Iowa, Des Moines, IA
- Veterans Administration Medical Center, Iowa City, IA
- Winneshiek Medical Center, Decorah, IA
Goal
The goal of the team is to facilitate effective and safe long-term anticoagulation therapy in all care settings in Iowa.
Status
The team has gathered information on current anticoagulation processes of anticoagulation clinics both in Iowa and nationally. Following the American College of Chest Physicians (ACCP) Guidelines the team has posted protocol examples for health care providers attempting to improve anticoagulation monitoring and treatment in their respective clinics and facilities. The forms selected contain all of the data elements necessary to successfully manage patient anticoagulation therapy according to the National Quality Forum Safe Practices and the ACCP Anticoagulation Management Guidelines.
1 Gurwitz, JH, et al., Incidence and Preventability of Adverse Drug Events Among Older Persons in the Ambulatory Setting, JAMA. 289:1107-1116, March 5, 2003.
View the IHC toolkits and their contents.
Resources for providers to ensure safe and effective long-term anticoagulation therapy in all care settings.
Information on how to deploy the NQF 30 Safe Practices.
Information that discusses how to better communicate medical information to patients.
Information on the monitoring and reporting of HAIs.
This process improvement method can help providers deliver more efficient care that saves resources and improves quality.
Details on the principles and components of a patient centered medical home, including the business case and how to become one.
Resources for providers to avoid adverse drug events.
Resources for the safe administration of narcotics and opioids.
Information and resources for providers in their efforts to assist patients with tobacco cessation.
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