Category: Federal Forum Posters
Purpose: The purpose of this study is to examine therapeutic outcomes and continuity of documentation within the Gulf Coast Veterans Health Care Services region before and after the implementation of a centralized anticoagulation clinic model. Long-term treatment/prophylaxis of vascular thromboembolisms and strokes with warfarin in anticoagulation clinics using the traditional office visit model has been the primary method for anticoagulation management. Recent evidence has suggested that transitioning the traditional clinic model to a centralized model, where the interaction between clinician and patient is over the telephone, yields similar therapeutic outcomes.
Methods: The 13 month time-frame of this study is centered on the anticoagulation centralization implementation date, July 16th, 2018, where 6 months pre-centralization and 6 months post-centralization will be compared. Data collection will be completed using the anticoagulation reports performed at the Veterans Integrated Service Network (VISN) 16 level and by physical review of approximately 10% of all anticoagulation electronic health records. Specific therapeutic data collection parameters are as follows: time within therapeutic INR range, clot and/or bleed events, and INR follow-up greater than 42 days. Specific chart documentation data collection parameters are as follows: pharmacist signature on note by close of business no later than 1 day after generating note and use of Veterans Affairs warfarin adjustment algorithm. Therapeutic outcomes will be assessed using the provided VISN reports, while continuity of documentation will be assessed using the electronic health records data. Clinical pharmacy specialists, total of 4 across the region, will be provided continuous feedback on both therapeutic outcomes and chart documentation through the use of monthly scorecards to allow for continuous quality improvement throughout the duration of this study.
Results: not applicable
Conclusion: not applicable
Frances Hoffman– PGY1 Pharmacy Resident, Gulf Coast Veterans Health Care System - JACC, Pensacola Beach, FL