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Tell us about the excellent care that happens in your service and help others learn from your experiences. Please share your example of an innovative and successful solution to challenges in patient care or service management. Examples should be specific and focus on one particular aspect of your service.

Please send your submission (maximum 500 words) to [email protected]. Please indicate your permission to include your name and email in the website posting so that colleagues can contact you directly with questions.

Thank you for sharing your Example of Excellence!

LRG Healthcare, Laconia, NH

Linda Horton, PharmD CACP ([email protected])

What Anticoagulation Clinics Can Learn from Pharmacy Students, Belichick, Brady and The Patriots

Anticoagulation clinics can learn a great deal from Patriot’s head coach Bill Belichick and quarterback, Tom Brady. Theirs is a culture of excellence and setting high expectations and not unlike the goals of the AC Forum. Leadership starts at the very top with the tone and direction set by our own Robert Kraft, or if you will, Jack Ansell. Jack’s leadership, passion and humility started this organization. The tradition has continued with David Garcia at the helm. As we all strive for anticoagulation excellence we have had some guidance from Garcia et al in Delivery of Optimized Anticoagulant Therapy: Consensus Statement from the Anticoagulation Forum, Rose et al in Organizational Characteristics of High- and Low-Performing Anticoagulation Clinics in the Veterans Health Administration and Katherine W. Philips and Jack Ansell in Outpatient Management of Oral Vitamin K Antagonist Therapy: Defining and Measuring High quality Management. The latest measure is “The Centers of Excellence”.

In our anticoagulation clinic at LRGHealthcare we have experiential sixth year pharmacy students who work along with the pharmacists in the clinic. As part of their assignments they are to identify an area of service that may be in need of improvement. They then are charged with coming up with an idea/project that will improve patient care and/or the operation of the clinic. This keeps us all in the mind-set of continually assessing our process, clinic and the service we provide to our patients. Just like the Patriots who after every game-win or lose review their performance.

Student projects have included:

A Feasibility Study to Expand Our Clinic, decreasing patient travel times/distances, improving patient compliance for visits and access to care. Our clinic is located in the rural, Lakes Region of NH and people drive great distances to obtain quality care. A survey was done and we now have 3 locations.

Wanted Poster: Notorious Drug Interactions these were distributed to community pharmacies, emergency rooms and nursing stations as well as the clinics to avoid dangerous drug interactions with warfarin.

New Patient Education Packets thereby standardizing the education process, putting all the education materials in one packet and making sure at least the basic information was given to each new patient. There are supplemental pieces to individualize the plan.

Centers of Excellence Designation as we move to accomplish this goal, the process have allowed us to identify areas that we need to improve, in order to receive this designation. Although not a richly culturally diverse population, New Hampshire does have a few people of ethnicity. We do have a medical foreign language interpreter service available to us to use with our patients but we have no written or other teaching materials for non-English speaking patients. Our student on this rotation will help us achieve this goal.

May we all think of the Patriots as we move towards excellence. Go Pats!

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