Reducing Medication Errors – Anticoagulation Medication SafetyAnticoagulants continue at or near the top of the list of medications that lead to ED visits and resulting hospital admissions. Anticoagulation therapy poses risks to patients and too often leads to adverse drug events due to complex dosing, requisite follow-up monitoring, and inconsistent patient compliance. The use of standardized practices for therapy that include patient involvement can reduce the risk of adverse drug events associated with the use of anticoagulant medications. Show
In 2009, the Joint Commission implemented a National Patient Safety Goal (NPSG 03.05.01) to reduce the likelihood of patient harm associated with anticoagulation therapy, and revised the NPSG to address direct oral anticoagulants effective July 2019. We're providing resources below to assist you in your work to improve anticoagulation management. We're especially appreciative of the Atrius Health clinicians and staff for taking the time to update their protocols and guidelines, and continuing to share their updates. This document is updated as we receive the latest information from Atrius Health (Alan Brush, MD, FACP, Chief, Cheryl Warner, MD, Senior Physician Consultant, et al). Atrius Health Anticoagulation Management Service Clinical Guideline and Practice Protocol – Revised July 2019, Alan Brush, MD Message from Alan Brush, MD, MD, FACP, Chief, Anticoagulation Management Service, Atrius Health with July 2019 revisions: We have created a new version of the Atrius Anticoagulation Management Service Guidelines and Practice Protocol to help support clinicians caring for patients on anticoagulation. Please remember, this document serves as a general management guideline based on a synthesis of multiple other recognized guidelines and cannot replace clinic judgment for any specific clinical situation. The new version comes on the eve of our pilot for Centralized Management of DOACs in the Atrius Anticoagulation Program, which has been developed with the support of a grant from the Risk Management Foundation. In this version, we have incorporated updated information on:
Note that our last update, April 2019, contained several changes related to external guidelines released in the previous year. Those changes included: Appendix 1: Guideline for Establishing INR Goal and Duration of TreatmentAtrial Fibrillation with stable CAD: Per CHEST 2018, we recommend anticoagulation with a DOAC or adjusted dose VKA rather than an oral anticoagulant and aspirin.Non Valvular Atrial Fibrillation
Safely Managing Patients on Warfarin-November 4, 2008 ProgramThe information shared at the Coalition’s 2008 programs may help clinicians and administrators of anticoagulation services adopt practices and tools for safely managing patients on warfarin. Anticoagulation Management In The Ambulatory Setting: Recommendations from the Massachusetts Coalition for the Prevention of Medical ErrorsNational Patient Safety Foundation Presentation - May 15, 2008,Physician Survey of Anticoagulation Management Barriers and Improvements Needed Massachusetts Medical Society 2007 Survey, Elaine Kirshenbaum, MPH Survey Summary of Findings, Joseph Dorsey, MD PresentationsCases and Questions from Strategies for Safely Managing Patients on Warfarin Program - November 4, 2008Optimizing the Management of Warfarin Therapy, Jack Ansell, MD Patients with AF: Who Should Be On Warfarin?, Daniel Singer, MDVulnerable Time During Patient Transitions, Terrence OMalley, MDAnticoagulation Transitions: Perioperative Care, Alan Brush, MD Massachusetts General Hospital Anticoagulation Management Service Clinic Backgroundand Communications, Lynn Oertel, MSStaffing, Budgets, and Reimbursement at MGH, Lynn Oertel, MSImproving Patient Care Management, UMASS Memorial Health Care, Pam Burgwinkle, ACNP-BC Staffing, Budgets, and Reimbursement at UMASS Memorial Health Care, Pam Burgwinkle, ACNP-BCHospital-Based Anticoagulation Clinic at Lahey Hospital Clinic, Ann Pianka, MSN Anticoagulation Management Service at Brigham & Womens Hospital, Cheryl Silva, Pharm D Other Clinical Guidelines and ProtocolsAnticoagulation Forum GuidelinesAntithrombotic Therapy in Atrial Fibrillation: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines, CHEST 2008, Daniel Singer, MDUnited Kingdom Anticoagulation GuidelinesCoverage Policies Coverage Policies ChartPatient and Family ResourcesPatient and Family ResourcesTools and Sample FormsJoint Commission Sentinel Event Alert AHRQ Resource MaterialsSample Patient Risk AssessmentClinical Transitions Definitions and Rationales - MGHAnticoagulation Management Service Brochure MGH AMSE-Z Guide for Optimizing Warfarin MGH AMSSample Patient and Physician Letters MGH AMS General Resources Surgeon General's Call to Action to Prevent Deep Vein Thrombosis and Pulmonary Embolism Patient Informational Website – MyBloodThinner.org – a site to help patients, caregivers, and health care providers manage oral anticoagulants, or blood thinners, more safely.Process Improvement in the Hospital Setting: Lessons for Successful Implementation of VTE Prophylaxis from the Rochester Regional Thromboembolism Collaborative , June 2008 – To download the Audio Conference, please click here. Prevention and Treatment of Venous Thromboembolism & Development of National Performance Measures, June 2008 – To download the Audio Conference, please click here.Anticoagulation Forum Consensus Statement, Jack Ansell, MDOutpatient Management of Oral Vitamin K Antagonist Therapy: Defining and Measuring High-Quality Management, Cardiovascular Therapy, 2008, Jack Ansell, MDQuality of Clinical Documentation and Anticoagulation Control in Patients with Chronic NonValvular Atrial Fibrillation in Routine Medical Care, American Journal of Medical Quality, 2007, Jack Ansell, MD North American Thrombosis Forum (NATF) – is a multi-disciplinary organization founded with the objective of improving patient care through the advancement of thrombosis education. Key References Key References What are the 6 National Patient Safety Goals?This is done to make sure that each patient gets the correct medicine and treatment.. Identify patients correctly.. Prevent infection.. Improve staff communication.. Identify patient safety risks.. Prevent mistakes in surgery.. Use medicines safely.. Use alarms safely.. What is an example of a National patient safety goal?Take extra care with patients who take medicines to thin their blood. Record and pass along correct information about a patient's medicines. Find out what medicines the patient is taking. Compare those medicines to new medicines given to the patient.
What is an elements of performance for the National Patient Safety Goals include?Element(s) of Performance for NPSG.02.03.01
Implement the procedures for managing the critical results of tests and diagnostic procedures. 3. Evaluate the timeliness of reporting the critical results of tests and diagnostic procedures. Improve the safety of using medications.
What is the purpose of the National Patient Safety Goals quizlet?Helps ensure quality health care through the development of standards for patient safety.
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According to the National Patient Safety Goals which type of therapy poses a risk to patients
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