Improving warfarin anticoagulation therapy in a community health system

An internal chart review of warfarin patients revealed a 44 percent complication rate resulting in higher treatment costs, and identified patient noncompliance, access to monitoring, and insufficient patient education as contributing factors. A warfarin usage guideline was created to assist physicians with warfarin management and subsequently the Anticoagulation Center (ACC) was established. To date over 950 patients have been managed through the ACC with therapeutic international normalized ratios an average of 82 percent of the time. Fewer bleeds and treatment failures have occurred in the ACC group, and a patient satisfaction survey revealed that ACC patients were very satisfied with their care more often than non-ACC patients.