NYSPFP ADE Optimizing Anticoagulation Care Series:
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1 NYSPFP ADE Optimizing Anticoagulation Care Series: Understanding Risks, Benefits, and Treatment Indications April A partnership of the Healthcare Association of New York State and the Greater New York Hospital Association
2 NYSPFP ADE Optimizing Anticoagulation Care Series Partnering with the Society of Hospital Medicine Engaging expert clinical faculty David Rosenberg, MD, MPH, FACP, SFHM Director, Evidence Based Clinical Practice Hospitalist, Department of Medicine Northwell Health Associate Professor of Medicine Donald and Barbara Zucker School of Medicine at Hofstra/Northwell David Coriale, RPh, PharmD, BCPS Clinical Pharmacy Manger Oneida Healthcare Kim Zammit, PharmD, BCPS, BCCCS, FASHP Clinical Pharmacy Coordinator, Kaleida Health Buffalo General Medical Center 2
3 NYSPFP ADE Optimizing Anticoagulation Care Series Webinars: Future dates to be determined April Webinar: Understanding Risks, Benefits and Treatment Indications July Webinar: VTE Prevention Who, What, Where, When, How... September Webinar: Transitions of Care for Patients on Anticoagulants 2018 In Person Conferences: The Nuts and Bolts of Anticoagulation NYC: Wednesday, May 16, 2018 Syracuse: Thursday, May 24,
4 Why Anticoagulants? Anticoagulants account for 17.6% of all ED visits for outpatient adverse drug effects, more than any other class of drugs Anticoagulants continue to account for large numbers of reported serious injuries (n=18,978) and deaths (n=3,018) in the US. Heparin and warfarin have been associated with medication errors more than many other medications Most adverse effects are preventable 4 Source: ISMP
5 NYSPFP Hospital Experiences
6 Anticoagulant ADE Measure Measure Type Measure Description Numerator Definition Process Measure Percentage of Supratherapeutic INR results of INR results with values >5 Denominator Definition of all INR tests resulted Data Submission Time Period Monthly Supratherapeutic INR mg/dl mg/dl ADE Rate Non- rural hospital cohort Baseline 1/17-6/17 Comparison Period 7/17-9/17 % Improvement May 18, 2018
7 VTE Measures Measure Type Measure Description Numerator Definition Denominator Definition Outcome Measure VTE rate per 100 adult inpatient discharges of facility-acquired VTEs among adult inpatient discharges of medical and surgical adult inpatient discharges VTE Rate Non- rural hospital cohort Baseline 1/14-12/14 Comparison Period 7/17 9/17 % Improvement May 18, 2018
8 VTE Measures Measure Type Measure Description Numerator Definition Denominator Definition Outcome Measure AHRQ PSI 12 Perioperative PE or DVT (secondary diagnosis) per 1000 surgical discharges for patients > 18 years old of surgical patients with hospital-acquired DVT or PE of adult surgical discharges 8 AHRQ PSI-12 (ICD 10) Non- rural hospital cohort Baseline 10/15-9/16 Comparison Period 7/17 9/17 % Improvement May 18, 2018
9 Agenda Topic Welcome and Introduction Series Overview Epidemiology of Thromboembolic Disease Risk of VTE and Treatment Speaker NYSPFP Staff Kim Zammit, PharmD, BCPS, BCCCS, FASHP Clinical Pharmacy Coordinator, Kaleida Health Buffalo General Medical Center David B. Coriale, RPh. PharmD, BCPS Clinical Pharmacy Manger, Oneida Healthcare Indications Closing Remarks and Q&A David J Rosenberg, MD, MPH, FACP, SFHM Director, Evidence Based Clinical Practice Northwell Health Hospitalist, Department of Medicine Associate Professor of Medicine Donald and Barbara Zucker School of Medicine at Hofstra/Northwell NYSPFP Staff 9
10 NYSPFP ADE Optimizing Anticoagulation Care Series Next Steps 2018 In Person Conferences: The Nuts and Bolts of Anticoagulation NYC: Wednesday, May 16, 2018 Syracuse: Thursday, May 24, 2018 Webinars: Future dates to be determined July Webinar: VTE Prevention Who, What, Where, When, How... September Webinar: Transitions of Care for Patients on Anticoagulants 10
11 Thank You! 11
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