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Mark Dewey, Pharm. D., BCGP, FASCP at 108 bed Lake Region Healthcare, Fergus Falls, MN

I have known Dr. Gulseth for over 20 years. When the pharmacy staff at Lake Region Healthcare (LRH) were being asked to increase their involvement in anticoagulation dosing and monitoring, I was asked what was going to be the best way to train our pharmacists. My first thought was, “Why not go to the expert in this area?” Dr. Gulseth has proven his expertise through his extensive training, research, and publications in anticoagulation. My next thought was, “We need to bring him to our facility.” Our facility could not afford to send our whole staff of pharmacists to a national meeting to get the type of training that Dr. Gulseth can offer. Also, I knew (from by history of knowing him personally and seeing his teaching skills in-action) that Dr. Gulseth has the passion and humor to make a full-day of learning, fun and interactive.

The large group of pharmacists and other health care professionals that attended the Anticoagulation University lectures and cases all rated the program extremely high. Our patients and facility will benefit from the information learned from Dr. Gulseth.

Nicole Shoquist, Pharm. D. at JPS Health Network, Fort Worth, TX (JPS Hospital, 537 beds)

In the fall of 2013, JPS Health Network invited Dr Gulseth to review our Anticoagulation Program. Dr Gulseth met with our staff and developed goals to form a seamless system of anticoagulation care across both our inpatient and outpatient settings. He provided suggestions for improvement and gave us ideas on how accomplish our goals. He was knowledgeable on EMR systems and how to construct metrics out of the accessible data. With these suggestions and ideas, JPS Health Network was able to move forward, implement multiple improvement projects and provide a higher and safer level of patient care.

Jan Puttbrese, Pharm. D. at 118 bed North Country Health Services, Bemidji, MN

Shortly after Dr. Gulseth’s book Managing Anticoagulation Patients in the Hospital was published, I asked my pharmacy supervisor whether he would consider extending an invitation to Dr. Gulseth to come to our facility and speak about implementation of the National Patient Safety Goals related to anticoagulation safety in the hospital setting. As the pharmacy liason to the Medication Safety Team, I felt that this text met many of the needs we had identified during our analysis of safety related to the use of anticoagulation—more specifically, helping us to identify gaps in our anticoagulation safety measures and providing our pharmacists and nurses with essential knowledge of anticoagulation.

During his visit to our hospital, Dr. Gulseth made a formal presentation to the nursing and pharmacy staff regarding anticoagulation safety. Additionally, he also met separately with the medical staff, members of our anticoagulation safety team and pharmacy staff, for more informal roundtable question and answer periods addressing concerns unique to our institution. Supporting literature and tools used by other institutions were shared. We received practical, real-world approaches to safety with direct application to our rural community based hospital.

His open and respectful approach to our rural, community based practice was very well received. His visit to our institution resulted in heightened awareness of anticoagulation safety issues, and resulted in increased administrative support for enhanced pharmacist involvement in the oversight and management of anticoagulation safety throughout our hospital

Subsequent publication of Anticoagulation Therapy: A Point-of–Care Guide continues to provide us with key information and needed guidance in keeping our patients safe.

Kevin Berg, R. Ph. at 267 bed St. Luke's Hospital, Duluth, MN

Shortly after starting my new position as clinical coordinator at St. Luke’s Hospital, I invited Dr. Gulseth to come to present a one day Anticoagulation Boot Camp for our staff. I wanted to revise the current warfarin dosing tool and provide the staff with additional information on anticoagulation therapies. With the information from Dr. Gulseth’s presentations, updating our warfarin dosing tool and some additional staff education, we were able to get our warfarin patients’ INRs into the therapeutic range nearly 1.5 days faster that with the old warfarin dosing tool. Our staff and patients have both benefitted from Dr. Gulseth’s presentations.

Gary F. Sigmeth, R.Ph at 21 bed, critical access hospital Mayo Health Systems-Cannon Falls, Cannon Falls, MN

I met Michael Gulseth about five years ago at a Minnesota Society for Health-System Pharmacists annual meeting where he was a presenter concerning systematic anticoagulation care provision. The Pharmacy needed to develop an anticoagulation program with the cooperation of the staff and management. This would need to follow the Joint Commission standards and I found that Michael had the expertise we needed.

Michael and I talked about the needs of our small hospital. He agreed to give a presentation at the hospital. Michael gave two presentations to accommodate staffing needs. In this presentation he stressed a collaborative service using all disciplines and teamwork for the best outcome. He had a very informative power point presentation along with handouts. He was available for all questions and addressed the needs of all levels of staff, including nurses, physicians, and mid-levels, that would be involved in the program.

Michael directed us through a pilot anti-coagulation program we developed. He was available by phone and email as we worked through documentation, scheduling and communication problems.

We now have a pharmacy directed anticoagulation service in compliance with Joint Commission standards. The pharmacist monitors all hospital patients and consults with the RN who is educated to monitor the clinic patients.

Michael’s expertise and professionalism allowed us to develop a program that is successful for the hospital and clinic patients.

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