Anticoagulation services: quality improvement direction pursuing a certification process. Anticoagulation Provider Certification Working Group.

There is still in a certification process for anticoagulant therapy providers. The primary, and certainly most important, goal is to improve patient care. Defining measurable competencies to which the anticoagulation provider is made accountable is but one mechanism to help improve quality in patient care. Great improvements have been achieved in the field of anticoagulation. For example, determining optimum intensity levels, for the traditional as well as the newer indications for treatment, have yielded greater efficacy and safety. Additionally, the acceptance of the INR reporting system has greatly reduced hemorrhagic and thromboembolic complications. However, the process of care, that is, how patients are managed and by whom, remains a variable that is difficult to quantify and measure. Anticoagulation providers are comprised of professionals from three major disciplines, namely, medicine, nursing, and pharmacy. This multidisciplinary approach enriches the quality of care for patients. However, this very fact presents a dilemma when seeking an appropriate certifying body. Nevertheless, keeping quality patient care as the primary focus, a multidisciplinary group has developed a body of knowledge that is unique to anticoagulant and antithrombotic therapies. The foundation of this project stems from the Fourth American College of Chest Physicians Consensus Conference on Antithrombotic Therapy and the recently published paper by Ansell et al. on consensus guidelines for coordinated outpatient oral anticoagulation therapy management. This work in progress includes a mission statement and outlines five major knowledge domains along with measurable competencies for each section. This effort will help standardized the process of care across the country.