Anti-coagulation Chart: Timeliness from SUHT to GP 2008
The objective of this retrospective audit is to improve the quality of information GP practices receive when inpatients are discharged from Southampton University Hospitals NHS Trust on anti-coagulation.

Please help us by completing this audit proforma for the patients in our sample and submit ONCE for each case.

SAMPLE:  The audit includes 100 Adult Patients identified as being on anti-coagulation at the point of discharge from hospital.  Your practice manager has the details of which of your patients are included in the sample.

Please could you submit all data by 31st July 2008.
 
Q1 PCT
 
 
 
   
Q2 Did you receive the Adult Oral Anti-coagulation Treatment Chart for this patient?
 
 
Q3 Was the Adult Oral Anti-coagulation Treatment Chart legible?
 
 
Q4 Please tick the number of days between the patient's date of discharge and your practice receiving the Adult Oral Anti-coagulation Treatment Chart for this patient:
 
 
 
 
 
 
 
   
Q5 Was the following information documented on the Adult Oral Anti-coagulation Treatment Chart?
   
  Indication for anti-coagulation  
  Target INR  
  Dose on discharge  
  Dose of next INR due  
  Duration of treatment  
Q6 Were newly prescribed interacting drugs highlighted on the chart?
 
 
 
Q7 Which of the following does the Anti-coagulation Chart indicate will manage the patient's ongoing anticoagulation?
 
 
 
 
Q8 Was the patient re-admitted to hospital as a result of an anti-coagulation error?
 
 
 
Q9 If the patient was re-admitted to hospital as a result of an anti-coagulation error what was the main cause?
 
 
 
Q10 Care Group:
 
 
 
 
 
 
 
   
 
 
   
Q11 Ward Name:
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
   
Thank you for participating in this audit.  

If you have any questions please contact the Clinical Effectiveness Team at Southampton Univeristy Hospitals NHS Trust 023 8079 4820
Q12
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Q14 snappublished@suht.swest.nhs.uk    Subject: Automated Data Receipt
 

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