Archbold’s Grady General Hospital was recently awarded a Leadership Award at the VHA Georgia 2015 Leadership Expo in Atlanta for the hospital’s initiative to reduce the likelihood of patient harm associated with the use of anticoagulation therapy. VHA Georgia, a membership alliance for not-for-profit health care providers that help member organizations meet the growing challenges of service to their communities, awarded GGH third place in the category for hospitals with 50-149 beds for the hospital’s submission titled, “Thinning Out the Issues: Improving Anticoagulation Therapy”.
According to the study by GGH, of all available pharmaceutical therapies, coumarin anticoagulants such as warfarin represent some of the most difficult-to-manage and dangerous drugs prescribed for patients. Published studies describe the risk of major bleeding or thromboembolic events due to warfarin therapy as between 2 percent and 12 percent per year. Anticoagulation care is commonly delivered over extended periods of time, and without complete clinical assessments, can be very dangerous for patients.
“Our primary goal for this initiative was to improve the quality and safety of care to our patients,” said Crystal Ramm, Grady General Hospital administrator.
To achieve the hospital’s goal of 90% compliance, the hospital pharmacy revised their warfarin monitoring tools and pharmacy-based dosing to improving patients’ therapeutic outcomes.
“We implemented several new protocols including warfarin education packets that are bar-coded and profiled by the pharmacy to ensure patient education is completed and becomes part of the medical record, said GGH pharmacist Leslye Upton, PharmD.“Safety alerts were built into the electronic pharmacy system, along with a computerized physician order entry, for each warfarin dose ordered and profiled to alert staff on laboratory orders and current INR values, which are calculations used to monitor patients who are on blood-thinning medication.”
Installation of a new software monitoring system helped staff standardize processes and improve safety, and the system gave real-time reporting on patients that could be accessed by any pharmacist.
“Nurses were educated on how to talk with their patients about warfarin and the safety measures our team put in place for patients taking the medication,” said Tammy Harlow, Grady General Hospital director of nursing. “Our nurses and physicians were on board for the implementation of this initiative, and they were educated on the new policies and procedures for administering the medication and managing patients that were given the medication.”
“Since implementing the initiative in 2010, our hospital has maintained or exceeded our goal of 90% compliance for the use of approved protocols at the initiation and maintenance of anticoagulant therapy and for education provided to staff, family and patients,” said Ramm. “The initiative was a multi-disciplinary effort, and it’s very rewarding for our team to be recognized for their efforts to make GGH a safer place for our patients. I’m very proud of our GGH team for being recognized in this way.”