Hello,

Our Hospitals / Medication Safety Committee are interested in implementing "protocols" to better manage the medication use process surrounding anticoagulants (especially related to patient monitoring). We already do a pretty good job of managing intravenous heparin and argatroban with pharmacist support and our EHR, however we have some potential gaps with our management of TSOACs / LMWHs. Would anyone we wiling to share their protocol, pathway, or order sets for LMWH / TSOAC? For example, do you require indications? Do you have routine laboratory monitoring defaulted in your EHR such as CBC or SrCr daily for three days? Do you see a lot of VTEP heparin combined with TSOACs as a therapeutic duplication with alert fatigue? A recent critical hemoglobin value on a "treatment" dose of LMWH and the ISMP Antithrombotic Self-Assessment is helping prioritize this project. We use SCM Allscripts for our EHR. Thank you!

Sincerely,

Jason Perry, PharmD, BCPS, LHRM, CPh
Medication Safety Officer