Abstract
Hospitalized patients are at increased risk of venous thromboembolism and the Joint Commission has initiated practice measures to improve the rates of preventable events. The Joint Commission also initiated the National Patient Safety Goals for medication prescribing and administration, of which, goal 03.05.01 is specifically aimed at anticoagulation therapy. These measures and goals are consistent with the American College of Chest Physicians’ Consensus Guidelines on Antithrombotic and Thrombolytic Therapy. This narrative review uses a case-based approach that brings up practical clinical questions regarding these measures, goals and guidelines as they apply to a patient going through the continuum of care from the hospital to their home.
Similar content being viewed by others
References
Geerts WH, Bergqvist D, Pineo GF, Heit JA, Samama CM, Lassen MR, Colwell CW, American College of Chest Physicians (2008) Prevention of venous thromboembolism: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Chest 133:381S–453S. doi:10.1378/chest.08-0656
The National Quality Forum (2006) Safe practice standards. Available via www.qualityforum.org
Caprini JA, Arcelus JI, Hasty JH, Tamhane AC, Fabrega F (1991) Clinical assessment of venous thromboembolic risk in surgical patients. Semin Thromb Hemost 17(Suppl 3):304–312
The Joint Commission (2009) Venous thromboembolism (VTE) core measure set. Available via http://www.jointcommission.org/PatientSafety/NationalPatientSafetyGoals/09_hap_npsgs.htm
Dentali F, Douketis JD, Gianni M, Lim W, Crowther MA (2007) Meta-analysis: anticoagulant prophylaxis to prevent symptomatic venous thromboembolism in hospitalized medical patients. Ann Intern Med 146:278–288
Cohen AT, Tapson VF, Bergmann JF, Goldhaber SZ, Kakkar AK, Deslandes B, Huang W, Zayaruzny M, Emery L, Anderson FA Jr, Investigators E (2008) Venous thromboembolism risk and prophylaxis in the acute hospital care setting (ENDORSE study): a multinational cross-sectional study. Lancet 371:387–394. doi:10.1016/S0140-6736(08)60202-0
Tapson VF, Decousus H, Pini M, Chong BH, Froehlich JB, Monreal M, Spyropoulos AC, Merli GJ, Zotz RB, Bergmann JF, Pavanello R, Turpie AG, Nakamura M, Piovella F, Kakkar AK, Spencer FA, Fitzgerald G, Anderson FA Jr, Investigators I (2007) Venous thromboembolism prophylaxis in acutely ill hospitalized medical patients: findings from the International Medical Prevention Registry on Venous Thromboembolism. Chest 132:936–945. doi:10.1378/chest.06-2993
Kahn SR, Panju A, Geerts W, Pineo GF, Desjardins L, Turpie AG, Glezer S, Thabane L, Sebaldt RJ, Curve Study Investigators (2007) Multicenter evaluation of the use of venous thromboembolism prophylaxis in acutely ill medical patients in Canada. Thromb Res 119:145–155. doi:10.1016/j.thromres.2006.01.0119
The Joint Commission (2009) 2009 National patient safety goals hospital program. Available via http://www.jointcommission.org/PatientSafety/NationalPatientSafetyGoals/09_hap_npsgs.htm
Warkentin TE, Greinacher A, Koster A, Lincoff AM, American College of Chest P (2008) Treatment and prevention of heparin-induced thrombocytopenia: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th edn). Chest 133. doi:10.1378/chest.08-0677
Kearon C, Kahn SR, Agnelli G, Goldhaber S, Raskob GE, Comerota AJ, American College of Chest Physicians (2008) Antithrombotic therapy for venous thromboembolic disease: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Chest 133:454S–545S. doi:10.1378/chest.08-0658
Crowther MA, Ginsberg JB, Kearon C, Harrison L, Johnson J, Massicotte MP, Hirsh J (1999) A randomized trial comparing 5-mg and 10-mg warfarin loading doses. Arch Intern Med 159:46–48
Ansell J, Hirsh J, Hylek E, Jacobson A, Crowther M, Palareti G, American College of Chest Physicians (2008) Pharmacology and management of the vitamin K antagonists: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Chest 133:160S–198S. doi:10.1378/chest.08-0670
Donovan JL, Drake JA, Whittaker P, Tran MT (2006) Pharmacy-managed anticoagulation: assessment of in-hospital efficacy and evaluation of financial impact and community acceptance. J Thromb Thrombolysis 22:23–30. doi:10.1007/s11239-006-8328-9
Matchar DB, Samsa GP, Cohen SJ, Oddone EZ, Jurgelski AE (2002) Improving the quality of anticoagulation of patients with atrial fibrillation in managed care organizations: results of the managing anticoagulation services trial. Am J Med 113:42–51 doi: S0002934302011312
Wilson SJ, Wells PS, Kovacs MJ, Lewis GM, Martin J, Burton E, Anderson DR (2003) Comparing the quality of oral anticoagulant management by anticoagulation clinics and by family physicians: a randomized controlled trial. CMAJ 169:293–298
van Walraven C, Jennings A, Oake N, Fergusson D, Forster AJ (2006) Effect of study setting on anticoagulation control: a systematic review and metaregression. Chest 129:1155–1166. doi:10.1378/chest.129.5.1155
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Kaatz, S. Impact on patient care: patient case through the continuum of care. J Thromb Thrombolysis 29, 167–170 (2010). https://doi.org/10.1007/s11239-009-0408-1
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11239-009-0408-1