177 The Current Landscape of Anticoagulation (AC) Stewardship Implementation Around the World: An International Survey

Results: We included 188 patients; 125 in pre-COE and 63 in post-COE groups.Mean time to first anticoagulant dose decreased from 233 to 221 minutes following COE implementation (p = 0.44).Preferential use of LMWH over UFH increased from 37.6% to 68.3% (p <0.001).The average number of completed ToC bundle components significantly increased from 3.7 out of 6 to 4.6 out of 6 (p <0.001) and anticoagulant-or VTE-related ED visits or readmission at 30 days significantly decreased from 10.3% to 1.8% in the post-COE group (p = 0.04).Conclusion: Upstream antithrombosis stewardship involvement in acute PE management is associated with improved patient management and outcomes.Broader implementation of the antithrombosis stewardship care delivery model has significant potential to optimize prescribing and use of high-alert, yet essential, antithrombotic therapies as well as improve healthcare resource utilization.