When a patient receives anticoagulant medications, the values of his or her laboratory coagulation tests tell clinicians whether dose adjustments are warranted. Laboratory values that are significantly out of range, or trending in an undesired direction, signal an increased risk of an adverse drug event. Therefore, it is critical that the results of these laboratory studies be available for clinician review in a timely fashion. You can improve provision of these important data by improving processes surrounding the tests. For example, review processes for how blood samples are collected and transported, how analysis is completed in the laboratory, and how results are reported.
The goal should be to have all coagulation test results available on the patient record within two hours from the time of sample collection. This may not be possible for all organizations, depending on whether or not the analyzing laboratory is on site or electronic reporting mechanisms are available. In those cases, use point-of-care testing equipment to conduct analyses at the patient’s bedside, which provides immediate results.
- Ensure that the two-hour limit for providing coagulation test results is measured from the moment the blood is drawn to the moment the results are on the patient’s record and available for review.
- Use point-of-care testing only on units with enough consistent volume so that staff competency can be monitored and maintained.
- Provide all the values over time, not just the most recent value. Computer-generated statistical process control charts of the values, for instance, can help identify trends.
- Include outpatient laboratory results for newly admitted patients whenever possible so clinicians can see data that cover a long period of time.
- Standardize the equipment for point-of-care testing.