Category: Federal Forum Posters
Purpose: Clinical practice guidelines recommend evaluation of the planned duration of oral anticoagulation (OAC) therapy for the treatment of venous thromboembolism (VTE) at specific intervals, with a goal to minimize unnecessary bleeding risk. These evaluations provide the most benefit to patients when they are performed in a timely manner and incorporate assessments consistent with current guidelines and the best available evidence. The purpose of this quality improvement (QI) project is to implement a standardized process for evaluation of the planned duration of oral anticoagulant therapy that is timely, evidence-based, and sustainable.
Methods: The Institutional Review Board (IRB) reviewed the project and determined it to be a non-research QI project. It will consist of two phases: in the first phase, a collaborative practice model will be established between primary care providers and anticoagulation pharmacists. This model will utilize protocols and a new evidence-based template to improve timeliness and consistency in evaluations. Pharmacists and providers will be educated on the new model, and the process will be implemented, with subsequent revision as necessary. The second phase of the project will be an assessment of the new process. Patients who received OAC therapy for treatment of a first acute VTE between August 1st, 2017 and March 31st, 2019 will be identified using reports generated from the electronic health record. Patients with cancer-associated VTE will be excluded. Each patient will then be assigned to either a pre-implementation group or a post-implementation group. Retrospective chart review will be conducted to obtain timeliness and consistency data for each patient, as follows: the number of days between documented evaluation request and evaluation completion, and the number of template components utilized in the evaluation. Distributive statistics will be used to compare the two groups on these outcomes.
Results: The implementation of a standardized process for evaluation is expected to decrease the number of days between request for evaluation and provider completion of evaluation, and to increase the number of recommended elements in the evaluation documentation. Results of this project will be presented in May at the 2019 Western States Conference.
Conclusion: The conclusion will be presented in May at the 2019 Western States Conference.
Mervan Newbold– PGY1 Rural Health Pharmacy Resident, VA Sierra Nevada Health Care System, Sparks, NV