Delivery of Optimized Inpatient Anticoagulation Therapy

Consensus Statement From the Anticoagulation Forum

Edith A Nutescu PharmD FCCP; Ann K Wittkowsky PharmD CACP FASHP FCCP; Allison Burnett PharmD PhC; Geno J Merli MD FACP; Jack E Ansell; David A Garcia MD


The Annals of Pharmacotherapy. 2013;47(5):714-724. 

In This Article

8. Outcomes

The inpatient anticoagulation system should measure pertinent quality indicators to assess the effectiveness of the system, analyze the impact on patient outcomes, and identify opportunities for improvement.

With health care costs rising rapidly, along with an increasing array of patient safety initiatives, there is increased pressure on health care facilities to evaluate their practices, report their findings, and look for ways to improve their performance. At stake is financial or accreditation punition for noncompliance. Continuous quality improvement is integral to the process of improving patient safety and optimizing outcomes while reducing costs. Within continuous quality improvement, there are 2 broad categories of quality indicators: process measures (how well the system works) and outcome measures (what impact the system ultimately has on the patient). The inpatient anticoagulation management system should be familiar with quality indicators pertinent to their organization, particularly those that are required by regulatory bodies such as Centers for Medicare and Medicaid Services and the Joint Commission. Table 9 provides some examples of quality indicators relevant to inpatient anticoagulation management. The institution's system should develop a method for tracking, reporting, and responding to these indicators. It is often challenging to identify resources, such as personnel or information technology, to accomplish this, and the multidisciplinary anticoagulation management team should anticipate these challenges and proactively plan for resource acquisition during the planning stages. It is recommended that findings be reported to key groups within the organization, such as an anticoagulation subcommittee, pharmacy and therapeutics committee, or hospital administration, on a regular basis to showcase progress of the inpatient anticoagulation system or highlight needs for additional resources or support.