# Developing an Implementation Strategy to Improve Peri-procedural Anticoagulation Management for Patients with Atrial Fibrillation

> **NIH NIH K01** · UNIVERSITY OF MICHIGAN AT ANN ARBOR · 2020 · $168,480

## Abstract

Abstract:
CANDIDATE: Geoffrey Barnes, MD, MSc is a cardiologist and junior clinical investigator focused on using
health system re-organization to improve anticoagulation-related care. Dr. Barnes' long-term career objective is
to combine health systems engineering principles (e.g. Lean and Six Sigma work flow model development and
optimization) along with implementation science approaches to improve the safety and coordination of
cardiovascular care, especially for anticoagulated patients with atrial fibrillation. The proposed K01 mentored
career development award includes a 5-year plan for training and research activities that will provide Dr.
Barnes with the necessary skills and experience needed to become a successful independent investigator.
RESEARCH CONTEXT: Over 500,000 patients each year who are chronically taking warfarin (an oral
anticoagulant) to prevent strokes related to atrial fibrillation require a temporary interruption of their
anticoagulant regimen for a surgery or procedure. Commonly, these atrial fibrillation patients receive shorter-
acting “bridging” anticoagulants (e.g. heparin) around the time of surgery to help prevent strokes. However,
robust evidence indicates that these shorter-acting bridging anticoagulants do not provide any stroke
prevention benefit, but do cause life-threatening bleeding. Anticoagulation clinics are staffed by expert nurses
and pharmacists to ensure safe and effective management of chronic warfarin anticoagulation. However, due
to a lack of coordination and communication within most healthcare centers, anticoagulation clinics are often
not involved in the peri-procedural management decisions about anticoagulant medications. There is great
need for a strategy to ensure safe, evidence-based peri-procedural anticoagulation care by re-organizing the
coordination between the surgical team and other providers (e.g. cardiology, primary care, and anticoagulation
clinic). The short-term goal of this proposal is to acquire the requisite skills in health systems engineering,
implementation science and organizational change leadership to develop and implement a peri-procedural
anticoagulation system re-organization that emphasized improved coordination and communication between
practitioners.
SPECIFIC AIMS: 1) Develop a re-organized model of peri-procedural anticoagulation care within six diverse
healthcare centers using health systems engineering methods; 2) Develop an implementation strategy for a re-
organized model of peri-procedural anticoagulation management of atrial fibrillation patients within a diverse
group of healthcare centers; and 3) Perform a single-center pilot study of implementing a re-organized peri-
procedural anticoagulation delivery model emphasizing improved intra-organizational provider coordination and
communication.
RESEARCH PLAN: To accomplish these aims, Dr. Barnes will perform direct observations and semi-structured
interviews with key stakeholders to develop and then optimize a wo...

## Key facts

- **NIH application ID:** 9844501
- **Project number:** 5K01HL135392-04
- **Recipient organization:** UNIVERSITY OF MICHIGAN AT ANN ARBOR
- **Principal Investigator:** Geoffrey Douglas Barnes
- **Activity code:** K01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $168,480
- **Award type:** 5
- **Project period:** 2017-01-01 → 2021-12-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9844501

## Citation

> US National Institutes of Health, RePORTER application 9844501, Developing an Implementation Strategy to Improve Peri-procedural Anticoagulation Management for Patients with Atrial Fibrillation (5K01HL135392-04). Retrieved via AI Analytics 2026-05-21 from https://api.ai-analytics.org/grant/nih/9844501. Licensed CC0.

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