Anticoagulants are the class of medications most commonly associated with adverse drug events (ADEs) contributing to emergency department visits and hospitalizations, and serious and preventable ADEs are also common in the acute and long-term care settings. In light of the considerable risk of harm associated with both bleeding and thrombosis and recognizing the complexity of care management across care settings and throughout periprocedural period intervals, a model for implementing anticoagulation stewardship has been developed and advanced by organizations led by the Anticoagulation Forum (AC Forum). ACCP collaborates with the AC Forum, with many ACCP members participating in and leading ACF efforts.
Following the trajectory of the highly successful and now-ubiquitous antimicrobial stewardship model, ACF developed the foundational Core Elements of Anticoagulation Stewardship Programs guide in 2019 under a contract with the FDA. In September of this year, with continued funding from the FDA and in partnership with the National Quality Forum (NQF), ACF developed Advancing Anticoagulation Stewardship: An Implementation Playbook.
NQF, a nonpartisan membership organization known for its review and endorsement of health care quality measures and development of playbooks pertaining to other high-risk drug classes (antibiotics, opioids), led the creation of the new playbook. Information for the playbook was collected through an extensive environmental scan, focused interviews with key informants, and an expert forum involving over 25 stakeholders. The gathered information was then distilled and synthesized into a playbook to provide detailed guidance on establishing new anticoagulation stewardship programs as well as strengthening and sustaining existing ones. Structured around the existing core elements, each section also identifies potential barriers and offers suggested solutions. Each section also provides links to an extensive array of references and resources to further guide sites looking to initiate, sustain, and grow stewardship programs.