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  • 1.  Anticoagulation visits

    Posted 05-19-2023 13:43

    We are looking at opportunities to engage our analytics team to develop a tool to use for auditing nurse managed anticoagulation visits. What audits/scorecards are being used for nurse managed anticoagulation visits? What data are other organizations pulling to find useful in managing the clinics?



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    Kathy Miller MSN
    Manager Regional Clinical Services
    OSF Medical Group
    Peoria, IL
    (309)645-8891
    Kathy
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  • 2.  RE: Anticoagulation visits

    Posted 05-23-2023 10:37

    Disclaimer: I  am a nursing and QI professional not actively managing an anticoagulation clinic----but here are some ideas:

    Patient's overdue for INR
    % of patients in therapeutic range
    Indications for anticoagulant therapy (gives perspective on risk and patient complexity)
    Patient satisfaction survey of clinic (can keep this very simple with 3-4 questions)
    Operating costs of clinic / Revenue generated from clinic
    Coding compliance
    Savings generated (ER visits and hospitalizations of clinic patients vs non-clinic patients for anticoagulant-related complications)
    Provider satisfaction with clinic services




    ------------------------------
    Leslie McDowell ANP-BC, DNP, RN
    QI Specialist / Curriculum Developer
    Northwest AHEC / Wake Forest University School of Medicine
    Winston Salem NC
    (336)972-7852
    ANP-BC, DNP, RN
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    Original Message


  • 3.  RE: Anticoagulation visits

    Posted 05-30-2023 11:11

    We screen patients at each INR check (in office or home tester) for the following items: 
    - Missing or taking extra doses of warfarin
    - Medication changes
    - Changes to diet that would effect INR
    - Changes to or initiation of alcohol consumption
    - Active bleeding

    The Anticoagulation Center for Excellence is a great resource, we use their tools to assess our program, 
    https://acforum-excellence.org/
    Thanks, Katharine 



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    Katharine Green BSN,RN
    Clinical Quality & Data Management
    Southwestern Vermont Medical Center
    katharine.green@svhealthcare.org
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    Original Message


  • 4.  RE: Anticoagulation visits

    Posted 05-31-2023 08:54

    We have had nurse led anticoagulation clinics for many years.  The data we collect to demonstration patient outcomes impacted by nursing are:

    • Time in therapeutic range
    • On time testing
    • Currently, we are working to add the amount of times patient's INR is >5.0

    We also are refining some of our productivity measures:

    • Panel size for RN (we include the FTE)
    • Number of telephone encounters
    • % of time available to schedule or unscheduled (depending upon how you look at it)

     

    Sue Weiss MHA, MM, BSN, RN

    Pronouns:  she, her, hers
    Chief Nursing Officer

    Vice President

    Medical Group – Advocate Midwest

    Working Remotely

       

     

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    Original Message


  • 5.  RE: Anticoagulation visits

    Posted 05-31-2023 09:12

    Does anyone capture the outcomes of Nurse assessments/interventions:

     

    1. Noting a change in patient's presentation with resultant new diagnosis ie: infection, thrombus, cancer, fall risk, etc... etc...
    2. Medication errors (pt's on drugs that are contraindicated and/or highly cautioned with coumadin use)
    3. Increased adherence to plans of care: Connecting with PCP and other specialist

     

    These are outcomes not easily captured, yet very unique to nursing's skills set. We need to find ways to capture these qualitative outcomes as well.

     

    Deb

     




    Original Message


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