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Toyosi Onwuemene: Why Anticoagulation Errors Persist Despite Strong Protocols
Toyosi Onwuemene/LinkedIn
Jun 16, 2026, 13:06

Toyosi Onwuemene: Why Anticoagulation Errors Persist Despite Strong Protocols

Toyosi Onwuemene, Associate Professor with tenure Duke University School of Medicine, shared a post on LinkedIn:

“A community health system pharmacist told me she reviews up to 10 anticoagulation-related safety events each week.

Not near misses.

Reportable events.

Her health system takes safety seriously.

  • They build more protocols.
  • They create more guidelines.
  • They add more EHR hard stops.

Yet the events keep happening.

Because anticoagulation errors often occur outside the guidelines:

  • The patient with bleeding and clotting risk.
  • The peri‑procedural hold for an urgent procedure.
  • The renal function that declined overnight.

Guidelines are built for standard cases.

Clinicians struggle with the exceptions.

Anticoagulation safety depends on how well your system supports clinicians when the case falls outside the protocol.”

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