Establishing an inpatient anticoagulation service: a step by step review.

Inpatient anticoagulation services can reduce medication errors, reduce hospital costs, and improve patient care. However, before a hospital establishes an inpatient anticoagulation service, it is important to conduct a thoughtful, systematic review of the institution. Two factors that can determine the need for an inpatient anticoagulation service are the number of adverse drug events and the extent of medical-legal liability at the institution. Establishing an inpatient service that reduces these problems can justify the cost of the program. In addition to these factors, the institution's infrastructure and the scope of services to be provided should be evaluated, and parameters should be created to measure the clinical and financial impact of the inpatient anticoagulation service. Numerous publications in the literature have supported the need and positive impact of inpatient anticoagulation services on hospital costs and patient care. The size and scope of the service should be based upon the needs, experiences and resources of a specific institution.