Magazine article Drug Topics

Hospitals Gearing Up to Meet Joint Commission's Anticoagulation Goals

Magazine article Drug Topics

Hospitals Gearing Up to Meet Joint Commission's Anticoagulation Goals

Article excerpt

The Joint Commission has set up a new National Patient Safety Goal (NPSG) that hospitals must meet this year. "Anticoagulation is a high-risk treatment, which commonly leads to adverse drug events due to the complexity of dosing these medications, monitoring their effects and ensuring patient compliance with outpatient therapy," stated the Joint Commission. To help hospitals prepare for this goal, an educational Webcast, sponsored by Premier Inc., was conducted recently on this subject.

According to the Joint Commission, the use of standardized practices that include patient involvement can reduce the risk of adverse drug events associated with anticoagulation medications such as unfractionated heparin, low molecular weight heparin (LMWH), and warfarin. Therefore, a new requirement (3e) was added to Goal 3 of die 2008 NPSG, which applies only to organizations that provide anticoagulation therapy. "The goal of the new requirement is to reduce the likelihood of patient harm associated with the use of anticoagulation therapy," stated Fred Pane, R-Ph., senior director, pharmacy affairs, Premier Inc.

The new requirement has a one-year phase-in period that includes defined expectations from the Joint Commission for planning, development, and testing milestones at three, six, and nine months in 2008, with full implementation by January 1, 2009. The first milestone has a target date of April 1, 2008, in which the organization's leadership should have assigned responsibility for oversight and coordination of the development, testing, and implementation of NPSG Requirement 3e. By July 1, 2008, there should be an implementation plan in place that identifies adequate resources, assigned accountabilities, and a timeline for full implementation by January 1, 2009, and a pilot test in at least one clinical unit is expected to start by October 1, 2008.

Geisinger Health System, a physician-led healthcare system in north central Pennsylvania, has established a systemwide team to review current anticoagulation processes and identify areas for improvement. To start the process, it established an interdisciplinary team, which included clinical pharmacists, members of the medical staff, nurses, and personnel from other areas. Geisinger's intent was to conduct a risk analysis, identifying potential failure modes in its system. "To approach our analysis, we used numerous resources to help us identify additional areas where we might be at risk," stated Dean Parry, R. …

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