Table 5.

Heparin-induced thrombocytopenia task force creation.

Intervention Type	Author	Year	Country	Intervention details	Preintervention group or time frame	Postintervention group or time frame	Findings
Task force with multiple goals
	Davis et al. [47]a	2005	USA	Formation of an HIT task force with a focus on reducing heparin exposure and developing aids for HIT diagnosis and treatment.	232 patients	204 patients	•Decreased adverse outcomes after HIT diagnosis: thrombotic/ischemic events (15.5% vs 8.3%, P = .022). •Increased warfarin initiation upon platelet recovery (80.4% vs 89.1%, P = .03). •Decrease in presentations with thrombosis (46.1% vs 37.8%, P = .08), and all-cause mortality (21.1% vs 16.7%, P = .243). •No difference in rates of DTI use within 1 d of suspicion of HIT (64.9% vs 67.5%, P = .593).
	Smythe et al. [45]/Smythe et al. [46]b	2012	USA	Implementation of a protocol for HIT recognition and management; guidelines for DTI use; refinement of ordering and documentation of HIT ELISA results in the EMR; and multidisciplinary education.	61 patients	46 patients	•Increase in DTI discontinuation within 12 h (19.4% vs 40%, P = .058) and 24 h (30.4% vs 61.5%, P < .05) of negative ELISA. •Higher rate of DTI initiation within 12 h of HIT ELISA ordering (25.8% vs 77.4%, P < .0001). •Reduced rate of thrombotic events (34.4% vs 13.0%, P = .01). •Reduction in major bleeding (13.1% vs 6.5%, P = .26). •Annual cost savings > $450,000.
	Reardon et al. [43]/Ritchie et al. [44]	2015/2016	USA	Hemostatic and Antithrombotic Stewardship task force created to provide clinical surveillance of HIT diagnostic workups and management of DTI therapy.	332 patients	259 patients	•Reduced median duration of DTI therapy (6.64 d vs 5.17 d, P = .01). •Reduced duration of DTI use for patients with suspected HIT (4.07 d vs 2.86 d, P = .01). •Annual cost reduction of $248,500.
	Lim et al. [42]	2018	USA	Implementation of multidisciplinary HIT task force; mandatory 4Ts score calculation prior to HIT ELISA ordering; treatment algorithm with automatic hematology consultation for intermediate-to-high risk patients; SRA ordering at discretion of hematology consultants; and widespread education to clinical staff.	2010	2013	•Reductions in HIT ELISA orders (600 in 2010 vs 374 in 2013, 13.5% decrease) and SRA (202 orders vs 29 orders, 85% decrease). •78% reduction in DTI use.

DTI, direct thrombin inhibitor; ELISA, enzyme-linked immunosorbent assay; EMR, electronic medical record; HIT, heparin-induced thrombocytopenia; SRA, serotonin release assay.

^aConference abstract.

^bMultiple publications on same data.