Patient-safe handover of anticoagulation care

People treated with anticoagulant medication by the Thrombosis Clinic deserve extra attention. This is especially important when they are admitted to hospital or return home again. In such situations, continuity of anticoagulation care is literally a matter of life and death.

Amphia Hospital and Star-shl’s Thrombosis Clinic have set up a link to ensure that systems and technology provide support to healthcare providers in optimising their integrated care.

Good integrated care is not always easy to achieve in actual practice. Anticoagulant medication is in the top five of avoidable Hospital Admissions Related to Medication (HARM, 2006). The highest risk was observed at the point of discharge from hospital to home. The handover form from the hospital was filled out by hand and faxed to the Thrombosis Clinic. It isn’t hard to imagine how time-consuming and error-prone this method can be. The Thrombosis Clinic often had to call the hospital to request additional information.

The Amphia Hospital and Star-shl have now structured patient handover in accordance with the National Standard for Integrated Anticoagulation Care 2.0 (LSKA 2.0, 2012). To that end, Amphia Ziekenhuis has set up a digital handover in the electronic patient file (EPIC). If a patient who is taking Vitamin K antagonists is discharged from hospital, the treating physician receives a warning that the Thrombosis Clinic must be notified. Also, the automatic digital handover form is largely pre-filled from the electronic patient file. The form is sent to the Star-shl Thrombosis Clinic via a secure connection.

Evaluation shows that the handover is no longer forgotten, the content is standardised and complete, and the form is easier to read. This ensures continuity, thus safeguarding patient safety.

The Thrombosis Clinic is currently exploring options for setting up the same method for other hospitals and chain partners.