PB1012 - Review of a Peri-operative mobile application to conform anticoagulation management and review of safety and clinician satisfaction.

Background: A proposal for the Musgrove Park Hospital Haematology service to manage peri-procedure anticoagulation bridging was made after several cancellations and key incidents were caused by inconsistent management. With limited resource the ‘Canadian Thrombosis’ application to guide anticoagulation in this setting was piloted within a revised clinical guideline.

Aims: To provide consistent, safe anticoagulation perioperative management according to an evidence base that the application has drawn from.

Formal documentation of a clearly defined plan for perioperative care within our electronic patient record system was shared with hospital clinicians, general practitioners and patients. Education and support was provided. The aim was to simplify the process, minimize variation and develop a single overarching, practical guideline to improve perioperative anticoagulation management in a medium sized acute hospital setting undertaking common surgical procedures

Methods: The guideline was introduced in October 2020. The following prospective data was collected: 30-day major bleeding events, thrombotic events and related mortality. The individualized patient plan provides clinicians with a guide to bleeding risk. As part of the evaluation of this service development, we reviewed patient and clinician satisfaction and compared this to operator satisfaction before the introduction of this new guideline. Data from the first 25 patients are presented here.

Results: Compliance with the guideline was excellent: all 25 patients had an anticoagulation perioperative plan documented in the electronic patient record. Clinical outcome was good: there have been no major bleeding or thrombotic events in the 21 patients who have progressed to surgery. All 15 clinicians involved reported increased user satisfaction relating to the change in application, clarity of plan, and patient outcome.

Conclusion(s): Use of perioperative anticoagulation guidelines based on the Canadian thrombosis application has resulted in improved patient care, high clinical engagement and user satisfaction with minimal resource requirements in an acute General Hospital setting