Performance measurement of a pharmacist-directed anticoagulation management service

The purpose of this study was to use a performance-driven organizational change framework to measure both the clinical performance and time performance of a pharmacist-directed anticoagulation management service. A sample of 286 consecutive encounters between patients and anticoagulation management service staff was selected over a 2-month period at the anticoagulation management service of a midwestern university medical center. Data were analyzed using descriptive statistics, logistic regression, and linear regression analysis. Regression-based estimates documented that patients with at least one regimen adherence problem were approximately 10 times more likely to be outside their clinical INR range (clinical performance issue) and required an average of 4 minutes more per encounter (time performance issue) compared with patients who exhibited no adherence problems. Performance metrics such as clinical and time performance can be useful for organizational adaptation and organizational growth decisions related to an anticoagulation management service.