Preventing Oral Anticoagulation Adverse Events

Oral anticoagulants are highly effective in preventing and treating thromboembolic disorders, and as the number of orthopedic and cardiovascular procedures continues to increase, the utilization and need for the agents has grown. But because of the unique and complex pharmacology of these agents, patient anticoagulation status is often “out of control”, contributing to adverse drug events (ADEs) – a significant cause of morbidity and mortality.

Improvements in prescribing, monitoring, and competency in clinical risk assessment to manage anticoagulated patients are clearly warranted. Best practices in anticoagulation care have been recognized and broadly implemented in other countries and in select settings within the U.S. (e.g. large academic medical centers with formal anticoagulation clinics). Unfortunately, only a small percentage of anticoagulated Americans have access to such providers, resulting in unacceptably high rates of ADEs.

As the Medicare QIO for New York State, IPRO is launching the “Preventing Oral Anticoagulant Adverse Events” initiative to engage anticoagulation providers and promote the use of best practices to achieve measurable improvements in anticoagulation care.

Our goal is to “mainstream” recognized anticoagulation best practices and demonstrate measurable improvement in anticoagulation-related care through participating healthcare providers across New York State. To reach this goal IPRO is collaborating with providers to implement a two-pronged approach:

1. Through an organizational framework, we are calling a “Learning and Action Network ” (LAN), IPRO is providing a forum for clinical leaders across the state to meet and lend guidance and expertise to direct the initiative. Through the LAN we will host educational programs and events for interested organizations and individuals to meet in a loose confederation in which clinical knowledge and best practices will be shared.
2. Through the second component, we are inviting provider sites to collaborate in teams on developing and implementing effective anticoagulation management. These teams – in partnership with the Health Resources and Services Administration (HRSA) successful Patient Safety and Clinical Pharmacy Services (PSPC) Collaborative -- collect clinical data for quality measures, investigate trends and outliers in patient data, review adverse events, and implement systematic improvements in processes of care.

Contact Us

Darren M. Triller, PharmD
Senior Director
(518) 426-3300 ext 125
dtriller@nyqio.sdps.org

Dianne Roux-Lirange, MSRN, PhD
Sr. Quality Improvement Specialist
(518) 426-3300 ext 106
drlirange@nyqio.sdps.org

Anne Myrka, RPh, MAT, BCPS
Pharmacist
(518) 426-3300 ext 191
amyrka@nyqio.sdps.org