Transcript Anticoagulation Audit - Quality Improvement Faculty

Overcoming the Challenges & Promoting Positive
Benefits
Julie Davies
AIM
 To enable Practices in Wales to review
their prescribing of oral
anticoagulation and to assess the
extent to which they comply with the
guidance issued by the National
Patient Safety Agency (NSPA, 2008)
National Patient Safety Agency (2008) Patient Safety Alert 18-Actions that can
make anticoagulant therapy safer. NSPA, London.
FACTS
 Anticoagulants are widely used. About 1%
of a practice population are on
anticoagulants at any time.
 Anticoagulants are associated with a
significant number of adverse drug events,
hospital admissions and death (NPSA,
2008)
National Patient Safety Agency (2008) Patient Safety Alert 18- Actions that can make
anticoagulant therapy safer. NPSA, London.
 The Primary Care Quality and
Information Service (PCQIS, 2010
updated)have developed an audit
toolkit to address processes which
could be implemented to improve
patient care.
The Primary Care Quality and Information Service (PQIS) (2010) Anticoagulation
(warfarin) Quality improvement toolkit. PCQIS, Public Health Wales, Wales.
 The audit toolkit provides the user with a
summary of the evidence directing the safe
use of anticoagulation medication, the
organisational components stipulated in
the nGMS contract (BMA, 2003) and a
schedule of patient review criteria to
compare current treatment against
evidence based criteria.
British Medical Association (BMA) (2003) GMS contract. National Enhanced service
Anticoagulation monitoring: supplementary document. BMA, London.
REVIEW AREAS
 Indication for anticoagulation
 Screening Investigations
 Anticoagulant drug dosage
 Alternative appropriate therapy
 Anticoagulation control
 Management plans
 Follow up
 Patient held records
CHALLENGES
 Coding issues
 Fragmentation of information
 IT
 Time & resources
 Communication
POSITIVE OUTCOMES
 Development and implementation of
an anticoagulant template to address
key issues
 Feedback to GP’s and other relevant
practice members
 Designation of a person to check that
correct coding is taking place
POSITIVE OUTCOMES (cont)
 Spread sheet with all the relevant
information in one place
 Professional Development
 Job satisfaction
 Benefits when re-auditing
Thank you for listening